Case Studies in Clinical Mass Spectrometry: An “Electronic Nose”

Case Studies in Clinical Mass Spectrometry: An “Electronic Nose”

Kalorama Information has profiled the unique and growing contributions of mass spectrometry technology to clinical in vitro diagnostics, and the pace of discovery in the field continues to impress. Researchers at the University of Leicester have developed an “electronic nose” capable of rapidly characterizing Clostridium difficile strains in infected patients. While the MALDI TOF form of mass spectrometry has been useful in identifying pathogens by cell surface proteins, the mass spec “electronic nose” under development detects various volatile organic compounds (VOCs) given off by C. difficile from patient fecal samples. The research touches on several pivotal areas of market development in IVD, namely hospital-acquired infections (HAIs), the diversification of clinical lab capabilities with the introduction of mass spectrometry, and intensifying clinical demand for faster turn-around and in-facility solutions to pathogen typing and characterization.

In the ninth edition of Kalorama Information’s The Worldwide Market for In Vitro Diagnostics Tests, analyst Shara Rosen described the clinical appeal of mass spectrometry:

In many laboratories, mass spec has replaced classical biochemical testing for bacterial identification in the past five years due to the accuracy, speed, extensive species coverage, ease of use and cost effectiveness of the system.

Although microbiologic culture is a standard method for detecting pathogens, this technique may take days to weeks. Specific PCR and serological assays are used to confirm the presence of a pathogen. Real-time PCR assays offer a rapid, sensitive, and specific method for the detection and differentiation of pathogens. But qPCR assays can only go so far; they do not drill down into the genetics of a pathogen to discover elements of virulence and antibiotic resistance.

The most promising aspect of the research at the University of Leicester is that clinicians can be more rapidly informed of infection strains and implement effective treatment. This form of diagnostic responsiveness - already driving the adoption of molecular testing at hospitals - could eventually see the placement of mass spec systems closer to patients at healthcare facilities and outside their current domain among reference laboratories.