Annals of laboratory medicine · 2026
Comparison of Bruker Biotyper Sirius, VITEK MS PRIME, and ASTA MicroIDSys MALDI-TOF MS Systems for Cryptococcus Species Identification Across Protein Extraction Protocols.
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Park Bosung, Suh Eunsang, Won Eun Jeong, Kim Tae Yeul, Huh Hee Jae, Sung Heungsup, Kim Mi-Na
Аннотация
BACKGROUND: Accurate and rapid identification of Cryptococcus spp. is critical for patient care. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is increasingly used for yeast identification; however, its performance varies with instrument and database coverage. We compared the performance of three MALDI-TOF MS systems-Bruker Biotyper Sirius (Sirius; Bruker Daltonics), bioMérieux VITEK MS PRIME (PRIME; bioMérieux), and ASTA MicroIDSys (ASTA; ASTA Inc.)-for detecting Cryptococcus spp. across protein-extraction protocols.
METHODS: We analyzed 51 C. neoformans, two C. deuterogattii, five Vanrija humicola, and one Naganishia liquefaciens clinical isolates. Each isolate was tested after on-plate formic acid extraction; isolates failing identification were retested after repeat on-plate and intube extractions. The results were categorized as correct, incomplete, incorrect, or no identification against ribosomal DNA sequencing results.
RESULTS: After initial on-plate extraction, correct identification rates were 86.4%, 88.1%, and 69.5% for Sirius, PRIME, and ASTA, respectively. After repeat on-plate extraction, ASTA accuracy increased to 81.4% (P =0.016). Additional in-tube extraction did not significantly improve identification across platforms, although PRIME outperformed ASTA (P =0.012). All platforms reliably classified C. neoformans (correct identification rates: 94%-96%) after additional on-plate extraction; discrepancies occurred mainly in uncommon species, possibly owing to gaps in database coverage.
CONCLUSIONS: Sirius and PRIME demonstrated robust performance for C. neoformans identification and C. gattii complex differentiation, outperforming ASTA for relatively rare species. Single on-plate extraction is sufficient in clinical practice. However, continued database expansion is essential for maximizing MALDI-TOF MS performance and accurately identifying Cryptococcus spp., thereby informing antifungal therapy and improving patient outcomes.
METHODS: We analyzed 51 C. neoformans, two C. deuterogattii, five Vanrija humicola, and one Naganishia liquefaciens clinical isolates. Each isolate was tested after on-plate formic acid extraction; isolates failing identification were retested after repeat on-plate and intube extractions. The results were categorized as correct, incomplete, incorrect, or no identification against ribosomal DNA sequencing results.
RESULTS: After initial on-plate extraction, correct identification rates were 86.4%, 88.1%, and 69.5% for Sirius, PRIME, and ASTA, respectively. After repeat on-plate extraction, ASTA accuracy increased to 81.4% (P =0.016). Additional in-tube extraction did not significantly improve identification across platforms, although PRIME outperformed ASTA (P =0.012). All platforms reliably classified C. neoformans (correct identification rates: 94%-96%) after additional on-plate extraction; discrepancies occurred mainly in uncommon species, possibly owing to gaps in database coverage.
CONCLUSIONS: Sirius and PRIME demonstrated robust performance for C. neoformans identification and C. gattii complex differentiation, outperforming ASTA for relatively rare species. Single on-plate extraction is sufficient in clinical practice. However, continued database expansion is essential for maximizing MALDI-TOF MS performance and accurately identifying Cryptococcus spp., thereby informing antifungal therapy and improving patient outcomes.