As medicine’s ability to support patients through periods of profound immunosuppression associated with cancer treatments and organ or bone marrow transplantation has improved over the past few decades, the number of fungal infections has increased. As with mycobacteriology, traditional phenotypic and biochemical methods of identification take days to weeks, especially for mold isolates. MALDI-TOF MS therefore can offer significantly shortened times for identification, which can have a significant effect on patient care.

Reliable identification of the most commonly encountered yeasts has been documented for both FDA-approved platforms, although significantly more independent studies exist for the Bruker system than for the bioMérieux system [2]. For many common yeasts, direct on-plate extraction works just as well as it does for bacteria. However, like mycobacteria, some fungi require protein extraction steps due to their stronger cell walls. Successful identification of these yeasts relies heavily on the adequacy of library databases.