Chapter 4.10 : Use of Matrix-Assisted Laser Desorption Ionization–Time of Flight for the Identification of Anaerobic Bacteria

Abstract:

The use of matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) for the identification of aerobic bacteria has begun to take hold in many clinical laboratories. A large amount of data has been published about how well it has performed for most aerobic organisms. There were a few articles early on about its use for the identification of anaerobic bacteria that suggested it needed improvements before it could be implemented in clinical laboratories; however, more recently, there have been at least 12 publications that demonstrate the potential for using MALDI-TOF for the successful identification of anaerobes as well, as has already been demonstrated for aerobes and other microbes. In this procedure, there will be a brief introduction into the principles of MALDI as they relate to the identification of bacteria, mention of the systems that have been or should be cleared by the US Food and Drug Administration (FDA) for use in clinical laboratories in the future, a summary of some of the work that has been done in the area of anaerobic bacterial identification, and a potential scheme for how it might be used routinely in the clinical laboratory for the identification of anaerobes. This procedure will not, however, describe the actual procedures for performing a MALDI-TOF in the clinical laboratory. Both of the products’ manufacturers and distributors, which have been cleared or are awaiting FDA clearance in the United States, have great technical teams and ample literature that can provide those procedures and suggestions for the use of MALDI in the clinical laboratory.