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Evaluation of the performance of Vitek MS and Bruker MS on the identification of Candida haemulonii species complex

HOU Xin;WANG He;XIAO Meng;LI Ying;XU Yingchun;Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases;Graduate School of Peking Union Medical College,Chinese Academy of Medical Sciences;  
Objective To evaluate the results of original identification,Vitek MS and Bruker MS identification of Candida haemulonii species complex collected from National China Hospital Invasive Fungal Surveillance Net(CHIF-NET)2010-2015.Methods A total of 40 Candida haemulonii and five Candida duobushaemulonii were collected from all hospitals in China as part of CHIF-NET 2010-2015.The original identification results were evaluated by setting the review results as "gold-standard",and the performances of Vitek MS and Bruker MS matrix assisted laser desorption ionization time of flight mass spectrometry(MALDI-TOF MS)in the identification of the C.haemulonii species complex were observed.Results As compared with the molecular identification,the accurate rate of original identification of C.haemulonii was 47.5%,while 15% of the strains were mistakenly identified as Kodamaea ohmeri and Cryptococcus neoformans by CHROMagar chromogenic media,ATB Rapid ID32 C,API 20 Cor Vitek 2 Compact system.C.duobushaemulonii could not be identified by using routine identification methods.As for the identification of the C.haemulonii,the accurate rate of the Vitek MS IVD2.0 and Bruker MS DB 5989 were 100%and 57.5%,respectively.There were no reference spectra for C.duobushaemulonii in the Vitek MS IVD 2.0 database,so it could not be identified by Vitek MS IVD 2.0 and misidentified all C.duobushaemulonii as C.haemulonii with confidence value90%.There were no reference spectra for C.haemulonii complex in the Vitek MS RUO database,so this complex could not be identified by Vitek MS RUO.20% of C.duobushaemulonii were identified correctly to species level by Bruker MS DB 5989.After complementation with the "in-house" database,all of the remaining isolates were correctly identified to species level.Conclusion This is the first study to evaluate the performances of Vitek MS and Bruker MS in the identification of C.haemulonii species complex in China.MALDI-TOF MS can provide rapid and accurate identification but is reliant on a robust mass spectra database.The performance of MALDI-TOF may be improved by adding mass spectral profiles into the current databases.
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