MALDI-TOF MS meets WGS in a VRE outbreak investigation

Eur J Clin Microbiol Infect Dis. 2017 Mar;36(3):495-499. doi: 10.1007/s10096-016-2824-4. Epub 2016 Nov 26.

Abstract

The use of MALDI-TOF MS (matrix-assisted laser desorption/ ionization-time of flight mass spectrometry) and WGS (whole genome sequencing) has been described for identification and strain relatedness determination. We describe the complementary use of MALDI-TOF MS and WGS in a VRE (vancomycin-resistant enterococci) outbreak investigation, and discuss some of the challenges with defining strain similarity across these two platforms. Although both assays indicated multiple clusters involved in the outbreak of vancomycin resistant Enterococcus faecium isolates from positive blood cultures of four haematology-oncology patients, the small cohort and discrepancies between findings indicate the limitations of MALDI-TOF MS and the cautious interpretation of MALDI-TOF MS dendrograms during outbreaks. For definitive determination of the evolutionary distance between isolates, WGS can be used.

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / microbiology
  • Bacterial Typing Techniques / methods
  • Disease Outbreaks*
  • Enterococcus faecium / chemistry
  • Enterococcus faecium / classification*
  • Enterococcus faecium / genetics
  • Enterococcus faecium / isolation & purification
  • Gram-Positive Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / microbiology
  • High-Throughput Nucleotide Sequencing / methods*
  • Humans
  • Molecular Epidemiology / methods
  • Sequence Analysis, DNA / methods*
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / methods*
  • Vancomycin-Resistant Enterococci / chemistry
  • Vancomycin-Resistant Enterococci / classification*
  • Vancomycin-Resistant Enterococci / genetics
  • Vancomycin-Resistant Enterococci / isolation & purification