Lab Med Online.  2022 Jan;12(1):40-45. 10.47429/lmo.2022.12.1.40.

Identification of Candida auris and Closely Related Species Using a New Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry, the ASTA MicroIDSys System

• Ma T
• In YH
• Byun SA
• Lee GY
• Choi MJ
• Lee SY
• Won EJ
• Choi HJ
• Choi HW
• Kee SJ
• Kim SH
• Shin MG
• Shin JH

• KMID: 2538582
• DOI: http://doi.org/10.47429/lmo.2022.12.1.40

Abstract

Candida auris is a multidrug-resistant fungal pathogen emerging worldwide that is closely related to the C. haemulonii species complex. The ASTA MicroIDSys (ASTA, Korea) is a new matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) system developed for species-level identification of microorganisms. However, prior to the current study, the reference database of ASTA MicroIDSys did not include C. auris. We expanded the database by adding 20 reference strains of C. auris and three closely related species belonging to C. haemulonii species complex. Further, we compared the performance of the ASTA system using an expanded database (coreDB v1.27.02) to that of the Biotyper system (Bruker Daltonics, USA) using 91 well-characterized Candida isolates from a Korean collection. In addition, we evaluated the ability of the ASTA system to differentiate between clade II and non-clade II isolates of C. auris. The results revealed that both ASTA and Biotyper systems accurately identified all 73 C. auris isolates. Of the 18 isolates of closely related species (nine C. haemulonii, seven C. haemulonii, and two C. haemulonii var. vulnera), the ASTA and Biotyper systems correctly identified 16 and 14 isolates, respectively, to the species level. Neither system misidentified any of the 91 isolates. Cluster analyses of the ASTA spectra distinctly discriminated clade II Korean C. auris isolates from the non-clade II isolates obtained from other countries. Our results show that the ASTA system with an expanded database is a reliable platform for the identification of C. auris and closely related species.

Keyword

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; ASTA MicroIDSys; Biotyper; Candida auris; Candida haemulonii; Candida pseudohaemulonii

Figure

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  Fig. 1 Heat map (A) and dendrogram (B) of mass spectrometry (MS) profiles generated by the ASTA system for 17 representative C. auris isolates (K1 to K17) from Korean hospitals and 20 internationally collected reference strains of C. auris and closely related species used for database expansion of the ASTA system (AR0381–AR0395, KCTC 17806–17810). The isolation year, source, and MLST type of the Korean isolates (K1 to K17) are shown following the species name (C. auris) of each isolate. (A) Columns show each strain of the species, rows indicate clustered m/z, and heat represents the degree of intensity. (B) The dendrogram is constructed by hierarchical clustering and is labeled with strain names. Strains were clustered by species, and strains of C. auris were clustered into clade II and non-clade II groups.

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