A Paradigm Shift from Research to Front-Line Microbial Diagnostics in MALDI-TOF and LC-MS/MS: A Laboratory's Vision and Relentless Resolve to Help Develop and Implement This New Technology amidst Formidable Obstacles

This chapter explores the various forms of matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS), tandem MS/MS proteomics for the characterization of human pathogens. The arrival of MALDI-TOF MS coincided with attempts to introduce 16S rRNA as a diagnostic method in public health laboratory service (PHLS). The success of MALDI-TOF MS has been underpinned by the ability to retain the basic platform on which to assemble the database. Work continued on microbial identification using MALDI-TOF MS, with the database now containing nearly all the National Collection of Type Cultures's (NCTC's) type and reference strains. Systems such as SELDI-TOF MS offer considerable advantage over traditional MALDI-TOF MS and used this approach recently to delineate the heterogeneity of Propionibacterium acnes. Although MALDI-TOF MS is widely used for proteomic and peptide mass fingerprinting, very few laboratories worldwide have applied this powerful technology for microbial genomics.