Clinical Evaluation of VITEK MS PRIME with PICKME Pen for Bacteria and Yeasts, and RUO database for Filamentous Fungi

VITEK MS PRIME (bioMerieux), a newly developed Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) system, alongside VITEK PICKME Pen (PICKME), offers easy sample preparation for bacteria and yeast. VITEK MS PRIME also offers two software platforms for filamentous fungi: the IVD database and the RUO database. Our study evaluated its identification agreement on 320 clinical isolates of bacteria and yeasts, comparing PICKME and traditional wooden toothpick sampling techniques against ASTA Mi-croIDSys Elite results. Additionally, we assessed the IVD (v3.2) and SARAMIS (v4.16) RUO data-bases on 289 filamentous fungi against molecular sequencing. The concordant rates for spe-cies-level identification of bacteria and yeasts were about 89.4% (286/320) between the PICKME and wooden toothpick, about 83.4-85.3% between VITEK MS PRIME and ASTA MicroIDSys Elite. Retesting with PICKME improved concordance to 91.9%. For filamentous fungi, species-level identification reached 71.3% with the IVD database and 85.8% with RUO, which significantly enhanced basidiomycetes' identification from 35.3% to 100%. Some strains in the IVD database, like Aspergillus vesicolor, Exophiala xenobiotica, and Nannizzia gypsea failed to be identified. VITEK MS PRIME with PICKME offers reliable and efficient microorganism identification. For fila-mentous fungi, combining the use of the RUO database can be beneficial, especially for basidi-omycetes.