MALDI-TOF MS is a method unlike any other in the clinical microbiology laboratory. As a result, laboratories have an opportunity to rethink their workflow so that they can take advantage of improved turn-around times offered by MALDI-TOF MS. Laboratory organization and workflow varies from institution to institution and is dictated by patient population served, test volume, operating hours, and many other factors. As laboratories consider implementing MALDI-TOF MS into their workflow, they will need to consider several key factors which will be discussed.
Laboratory Information System (LIS) and Instrument Interface
Most clinically relevant microorganisms that are definitively identified in the laboratory will have antimicrobial susceptibility testing (AST) performed as needed. With the implementation of MALDI-TOF MS, laboratories will have to evaluate how best to integrate the microorganism identification with the AST. AST systems require that identification be provided to assess correct antimicrobial interpretations before releasing results to the LIS. It then becomes important to consider how the MALDI-TOF MS will be interfaced. Will the instrument interface directly with the AST system or will it communicate with the LIS? Depending on the capability of the laboratory, the MALDI-TOF MS system being used, and the type of AST performed (e.g., automated minimum inhibitory concentration (MIC) versus Kirby-Bauer), laboratories may not be able to interface with either and will have to manually enter their information into the LIS or AST system.
