MALDI-TOF applications in the clinical microbiology lab: saving time we save lives

Tailoring rapid and accurate antibiotic treatment to severely ill patients is crucial for their favorable outcome. For that aim, the microbiology laboratory should deliver prompt identification of the causative organism along with its antibiotic sensitivity profile. In the last few years, mass-spectrometry represented by the MALDI-TOF technology was introduced to the clinical microbiology laboratory. This technology has revolutionized the identification of bacteria and fungi shortening it to minutes and is now the most prominent tool for identification in clinical laboratories. Additional applications are rapid antimicrobial sensitivity testing (AST), shortening the results from 18-24 to 2-3 hours and bacterial subtyping, which allows the rapid investigation of outbreaks and cross-contamination events among hospitalized patients. In the era of increasing antimicrobial resistance, the precise yet cautious use of antibiotics is mandatory. Thus MALDI-TOF technology not only allows for rapid identification but may also guide the antibiotic treatment improving both patient outcome and antibiotic stewardship. The current applications of MALDI-TOF technology and future trends in the clinical microbiology laboratory will be described.