Interests and current limits of MALDI-TOF in clinical bacteriology

Until the early 2000s, in the clinical microbiology laboratories, the bacterial identification was based mainly on the biochemical analysis of phenotypic characters whose interpretation required expertise. In most cases, the results was obtained after more than 18 h. When it was taken in default, the identification was mainly obtained by molecular biology analysis such as 16S rDNA sequences. For nearly 5 years, using MALDI-TOF mass spectrometry machine revolutionized bacterial identification in clinical bacteriology laboratories. From bacterial colonies, the results of reliable identifications are easily obtained in less than 5 minutes. These advantages have greatly contributed to its success. When a laboratory is equipped by this device, the bulk of the identifications are provided by this new approach. The objective of this review is to analyze the reasons of the success of MALDI-TOF in clinical bacteriology, to know its present limitations and new applications. (C) 2012 Elsevier Masson SAS. All rights reserved.