MALDI TOF MASS SPECTROMETRY AND ITS FUTURE CLINICAL...
Transcript of MALDI TOF MASS SPECTROMETRY AND ITS FUTURE CLINICAL...
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MALDI TOF MASS SPECTROMETRY AND ITS FUTURE CLINICAL IMPACT Alex van Belkum Global Director, Research and Development Microbiology bioMérieux SA, La Balme Les Grottes, France Honorary Professor in molecular Microbiology Erasmus Medical Center Rotterdam, The Netherlands
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“MODERN” CLINICAL MICROBIOLOGY PRACTICE
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THE NAME GAME
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CULTURE IS NOT DEAD!!
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MASS SPECTROMETRY
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SPECTRUM ACQUISITION
Let the spot dry
With 1µL-loop
take a small piece
of one colony
1µL HCCA matrix YEAST 0.5 µL formic acid
Sample scan on Preparation Station
BACTERIA MALDI TARGET
Let the spot dry
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MS DATABASE CONCEPTS
Population based Strain based
Species represented by populations
Species specific characteristics can be
revealed
Many reference strains required
Species represented by individual
strains
Rapid database building
Strains not necessarily represent
typical isolates
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MS DATABASE CONCEPTS
Population based Strain based
Bruker BioTyper VITEK MS (IVD) SARAMIS (RUO)
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PATTERN MATCHING
Sample spectrum
Reference spectrum
Perfect match:
0 distance between
peaks
Less perfect match:
Sum of distances
between peaks
SARAMIS (RUO) v4.10
Analysis using
ReferenceSpectra
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Study by Jean Philippe Charrier and co-workers
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PATHOGEN TYPING??
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PATHOGEN TYPING!!
Diversity of spectra depending on strain origin:
Trichophyton interdigitale
Zoophilic
Anthropophilic
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Determination and characterization of β-lactamase activity in bacterial lysates using MALDI mass spectrometry Gero P. Hooff1*, Jeroen J.A. van Kampen2, Roland J.W. Meesters1, Alex van Belkum2,3, Wil H.F. Goessens2, Theo M. Luider1
ANTI-MICROBIAL SUSCEPTIBILITY TESTING
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CIRCULATING PROTEASES IN ANTHRAX INFECTION
Late in infection large amounts of Lethal Factor (LF) toxin are produced
by Bacillus anthracis. LF is a protease attacking members of the
mitogen activated protein kinase kinases (MAPKK) and thereby blocking
cell signalling pathways. This suggests that artificial substrates for LF
might be used as diagnostic targets. Recognition site mimicking
peptides were developed.
Website P. Rizkallah, endorsed by MRC & NIH
VIRULENCE ASSESSMENT?
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PROTEOLYSIS OF REPORTER PEPTIDES
Courtesy of Floris Bikker and Wendy Kaman,
TNO Defense, Rijswijk, The Netherlands
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DIRECT BC TESTING
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DIRECT TESTING OF URINE SAMPLES
Negative urine sample
Positive urine sample
E.coli 105 CFU/mL
E.coli calibrant ATCC 8739
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MAIN ACTIVITIES
New protocols for molds, Mycobacteria and Nocardia (2 patents filed)
Adapted to the lab workflow (solid media for molds)
Allows Mycobacteria inactivation
VITEK MS database expansion
Clinical molds (Bellinzona, CBS, San Antonio)
Mycobacteria (HUG Genève, Durham)
Legionella (CNR, Bellinzona)
BSL3 species (CNR Brucella and Arizona university)
Strains from cystic fibrosis patients (HCL Lyon)
Environmental strains (Baseclear, Baxter)
Veterinary strains (Copenhague, LDV Perigueux)
New update planned in Q4 2013 : 1000 species in total
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Inactivation/Extraction Method for Mycobacteria (Ethanol - Formic Acid 70% - Acetonitrile) - Solid Culture
Transfer suspension to
empty Eppendorf tube
(a) Please note that depending on the instrument, the centrifugation time may need to be adapted (for example 2’30 min in order to have 2 min at 10,000 rpm). Moreover, if
you need to put the tubes outside of the safety cabinet for the centrifugation steps, take care to clean the tubes with sporicidal product in order to avoid contamination.
Use a safety cabinet, wear laboratory coat and gloves
Use the appropriate procedure/product for disinfection
In 40 µ L FA [70%] +
2&3
3 3
Bead beat for 5 min and
then incubate at room
temperature for 10 min
Suspend one 1 µl
loopful of growth in
500 µl EtOH (in
Eppendorf tube
containing 0.5 mm
glass beads
Discard the EtOH
supernatant using a
Pasteur pipette
Add 10 µl 70% formic acid, (vortex, and
incubation at room temperature for 2-5 min
Add 10 µl acetonitrile and vortex
Centrifugation
2 min @
10,000 rpm (a)
Deposit 1 µl supernatant
Dry completely
Add 1 µl CHCA matrix
Dry completely
Analyze in VITEK MS
This step could be done on the bench outside the safety
cabinet
Centrifugation
2 min @
10,000 rpm (a)
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ASSOCIATED RESEARCH
Antibiotic resistance
Detection of enzymatic activities (b-lactamase)
Analysis of cell wall components (porins)
Biomarker detection
Glycans as marker of fungal infections (Pr Poulain, Lille)
LPS modification
Detection of LPS modification linked to biofilm formation
(Institut Pasteur)
Detection of virulence factors (shiga-toxin)
Typing (Legionella)
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(SOME) ACKNOWLEDGEMENTS
Microbiology R&D bMx Durham
Jay Hyman, John Walsh, Michael Dunne, Marc Van Nuenen
Microbiology R&D bMx La Balme Les Grottes
Sylvain Orenga, Geraldine Durand, Martin Welker, Sonia Chatellier
ESPCL Paris
Andrew Griffith
Geneva
Jacques Schrenzel
Rotterdam
Wil Goessens, Theo Luider
Boston
Howard Shapiro, Scot Manalis
Grenoble
Frederic Mallard
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CURRENT bMx AND PAST ROTTERDAM FRIENDS AND COLLEAGUES
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