Performance and workflow comparison of the VITEK MS PRIME and Bruker Biotyper MALDI-TOF MS systems

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is widely used for rapid identification of bacteria and yeast in clinical labs. The VITEK MS PRIME ("PRIME") is the latest MALDI-TOF MS system from bioMérieux. This study evaluated PRIME's performance and workflow timing against the MALDI Biotyper CA System by Bruker ("Biotyper"). We compared a collection of 154 bacteria and yeast clinical isolates from various specimen types using three methods: Biotyper target with a toothpick, PRIME target with the PICKME nib, and PRIME target with a loop. Positive blood culture isolates were also analyzed using these methods, with high-experience (HEU, n = 300) and low-experience users (LEU, n = 50) after short (6-8 h) and routine (18-24 h) incubation on agar plates. Workflow timing, from sample processing to organism identification, was assessed to identify time savings. PRIME identified 96% (PICKME) and 95% (Loop) of challenge isolates to genus level, compared with Biotyper at 99%. Short incubation of positive blood culture isolates demonstrated similar species-level identification rates across all methods (Biotyper: 84%, PRIME PICKME: 80%, PRIME Loop: 81%), although more repeats were needed compared with routine incubation. No difference in species identification occurred between users for any method at short incubation (89%-91%, HEU, vs 79%-85% LEU). Single-target process times were comparable for all methods (55-59 min), whereas PRIME methods had shorter hands-on times for analysis of multiple targets (Biotyper: 53 min, PRIME PICKME: 39 min, PRIME Loop: 40 min). These findings highlight the comparable performance of the PRIME and Biotyper systems while demonstrating the potential for time savings with PRIME workflows, particularly in high-throughput settings.IMPORTANCEThis study provides a critical evaluation of the new VITEK MS PRIME MALDI-TOF MS system, comparing its performance and workflow efficiency against the Bruker MALDI Biotyper. The study investigates the success rate of isolate identification from short incubation of positive blood cultures, illustrating the utility of this technique for downstream workflows such as faster reporting of results for patient management and isolate identification for interpretation of rapid phenotypic AST. Analysis of different workflows demonstrated areas for potential time savings, particularly in high-throughput settings. These findings highlight the importance of optimizing MALDI-TOF MS workflows in the era of workforce shortages and lab centralization to enhance rapid pathogen identification and improve patient care.