MALDI-TOF MS: Foundations and a Practical Approach to the Clinically Relevant Filamentous Fungi Identification

Abstract

In this review, the applicability of matrix-assisted laser ionisation/desorption time-of-flight mass spectrometry (MALDI-TOF) to the identification of clinical relevant filamentous fungi is presented. In addition, the need to implement and validate in-house databases, to fill the gaps in commercial databases, and the importance of permanently updating spectra databases are topics addressed. MALDI-TOF MS is recognised as a powerful tool for discriminating complex and cryptic fungal species, as well as for strain typing of filamentous fungi of medical importance. MALDI-TOF MS is a versatile technique and an undeniable tool for identification of filamentous fungi as part of the routine of a clinical mycology laboratory. The application of standardised procedures for the implementation and validation of the in-house databases, as well as for the identification of clinical isolates, is essential to obtain results that are comparable to those obtained through sequencing.