Proof-of-concept study demonstrates limited isolate-level antifungal susceptibility classification in Aspergillus, indicating AI-assisted mass spectrometry requires further optimization.
Background: species using routine matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS). Methods: (N=22), based on categorical agreement (CA), very major error (VME), major error (ME), sensitivity, and specificity. Results: Although spectrum-level evaluation showed excellent analytical discrimination, isolate-level clinical evaluation demonstrated limited performance across seven species-antifungal agent combinations. Across these combinations, the AI models achieved a mean CA of 56.0%, with VME and ME rates of 53.3% and 45.2%, respectively. Sensitivity ranged from 0% to 100% and specificity from 18.2% to 87.5%, indicating inconsistent susceptibility classification performance across species-antifungal agent combinations. Conclusions: spp. However, its clinical performance across species-antifungal agent combinations was limited. Further optimization, evaluation with larger multicenter datasets, and external validation are required before considering clinical adoption.
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Lee et al. (2026) studied this question.
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