AvB is a microbiologist with an extensive academic background. He has PhD degrees from the University of Leiden and the Erasmus University of Rotterdam, both in The Netherlands. AvB joined bioMérieux over ten years ago and has had several posts within the company’s microbiology R&D departments. AvB has been involved in the development of the Vitek MS instrument and accompanying databases and is still involved in critical assessment of the performance of the technology. AvB has published close to 600 PubMed cited papers and has a a Google Scholar defined H-index of over a 100.
Matrix Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry (MALDI ToF MS, here “MALDI”) is a recent technological addition to the diagnostic armamentarium of clinical microbiologists. An amount of about ten thousand bacterial cells suffices for adequate identification of a microbial species. Bacterial cells are subjected to MALDI and the resulting spectra are identified via cross correlation of the experimental spectrum with those embedded in extensive databases. Software packages developed to provide microbiologists with push-button identification assays are available and the intricate use of such protocols will be described in another presentation in the symposium (Katleen Vranckx). In addition to microbial identification MALDI is progressively used for detailed microbiological identification. First, microbiologists are expecting the technology to play a more important role in antimicrobial susceptibility testing (AST). MALDI-based AST formats have been proposed and their pro’s and con’s will be discussed. Currently there are no routinely used MALDI AST formats that meet the general diagnostic requirements. Second, epidemiology is important for tracing local but also more extensive outbreaks of infectious diseases. Again, different approaches using MALDI data have been proposed and successful application of “MALDI typing” has been reported regularly. The impact and importance of such tests will be discussed. Thirdly, there is a new tendency to use MALDI spectra in combination with other databases (clinical patient data, epidemiological information, data on disease severity and others). This should lead to a more prospectively oriented diagnostic approach on the basis of which MALDI data should serve to better predict disease outcome, to propose more optimal patient management and enhanced return on MALDI investment. The presentation will cover the three main additional diagnostic approaches next to microbial identification and will try to sketch a future perspective for improved use of MALDI data in the field of clinical microbiology and infectious diseases.