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| Accuracy and Clinical Significance of MALDI-TOF MS in Identifying Acinetobacter Hospitalis and Acinetobacter Baumannii |
| CHEN Yan, HAN Qingzhen, ZHANG Ting |
| Clinical Testing Center and Innovation & Transformation Platform, the Fourth Affiliated Hospital of Soochow University, Suzhou Jiangsu 215123 |
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Abstract 【Objective】To investigate the accuracy of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in identifying Acinetobacter hospitalis (A. hospitalis) and Acinetobacter baumannii (A. baumannii), and to analyze the clinical features and antibiotic resistance differences between the two species in order to evaluate the impact of misidentification on clinical diagnosis and treatment.【Methods】MALDI-TOF MS results were compared with those of first-generation sequencing in 18 patients infected with A. hospitalis and 115 patients infected with A. baumannii. Their clinical characteristics and antimicrobial susceptibility data were analyzed.【Results】MALDI-TOF MS achieved an identification accuracy of 100.0% for A. baumannii, but only 66.67% for A. hospitalis, with an overall accuracy rate of 93.98%. Patients with A. hospitalis infection had significantly longer hospital stays than those with A. baumannii infection (P<0.05). Resistance rates to most antibiotics were higher in A. baumannii than in A. hospitalis (P<0.05).【Conclusion】MALDI-TOF MS demonstrates high accuracy in identifying A. baumannii but a relatively high misidentification rate for A. hospitalis, which is often incorrectly identified as A. baumannii. Although the clinical infection characteristics of the two species are similar, A. hospitalis infections are associated with longer hospitalization and significantly lower antibiotic resistance compared to A. baumannii. Therefore, when the two cannot be reliably distinguished in clinical practice, antimicrobial susceptibility testing should be performed whenever possible to guide antibiotic therapy.
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Received: 14 July 2025
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2025, Vol. 42 
