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Identification of Neisseria meningitidis by MALDI-TOF MS may not be reliable

E Hong1, Y Bakhalek1, M-K Taha1

  • 1Institut Pasteur, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci, Paris, France.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|October 6, 2018
PubMed
Abstract

Insights

Enhancing the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) database with whole genome sequencing (WGS) reference strains significantly improved Neisseria meningitidis identification. This update is crucial for accurate diagnosis and management of meningococcal disease.

Area of Science:

  • Microbiology
  • Genomics
  • Mass Spectrometry

Background:

  • Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is widely used for microbial identification in clinical laboratories.
  • Accurate identification of Neisseria meningitidis is critical for managing invasive meningococcal disease and implementing timely public health interventions.
  • The performance of MALDI-TOF MS can be variable, particularly for genetically diverse species like N. meningitidis.

Purpose of the Study:

  • To assess and enhance the identification accuracy of Neisseria meningitidis using MALDI-TOF MS.
  • To improve the MALDI-TOF MS database by incorporating reference strains characterized by whole genome sequencing (WGS).

Main Methods:

  • A collection of 24 Neisseria strains was characterized using WGS.
  • This curated collection was added to the existing MALDI-TOF MS database.
  • The performance of the enriched database was evaluated using 32 clinical isolates of N. meningitidis.

Main Results:

  • Initial identification using the standard commercial library showed only 67% concordance with WGS.
  • Enriching the database with WGS-identified reference strains significantly improved N. meningitidis identification.
  • The specificity for N. meningitidis identification increased from 52% to 92% with the enhanced database.

Conclusions:

  • The study underscores the necessity of updating MALDI-TOF MS databases with high-quality, WGS-verified reference strains.
  • Improved identification of N. meningitidis via MALDI-TOF MS can prevent misdiagnosis and unnecessary public health actions.
  • Database enrichment is a viable strategy to enhance the reliability of MALDI-TOF MS in clinical microbiology.
Keywords:
IdentificationMALDI-TOF MSNeisseria meningitidisWhole genome sequencing

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