The IR Biotyper as a tool for typing organisms of significance for hospital epidemiology- A subject review

The IR Biotyper is a novel real-time typing tool, based on a Fourier-transform infrared (FTIR) spectroscopy system. It has emerged as a promising method for the strain typing of various microorganisms and for the detection of their clonal spread within hospitals. In this review, we aim to present the applications and accuracy of the IR Biotyper in hospital epidemiology. Twenty-nine studies that evaluated the use of IR Biotyper for organism strain typeability and outbreak investigations within hospitals, were included in our review. Twenty studies assessed gram negative bacteria, seven studies assessed gram positive cocci, three studies assessed Candida spp., and one study assessed Mycobacterium abscessus complex (MABSC). A total of 3140 isolates were typed in the studies included in this review. The overall average accuracy of the IR Biotyper for typing of all organisms assessed was 84 % (SD: 22, 95 % CI: 83-85). Higher accuracy was achieved among glucose non-fermenting gram negative bacilli (93 %, SD: 12, 95 % CI: 93-94), followed by gram positive cocci (84 %, SD: 10, 95 % CI: 83-84), Enterobacterales (78 %, SD: 20, 95 % CI: 76-80), and Candida spp (56 %, SD: 26, 95 % CI: 52-60). Summary: The IR Biotyper may be a promising strain typing tool with useful utility within hospital settings. The tool provided microbial strain discrimination at an effective turnaround time, with comparable accuracy as genome-based methods for most organisms assessed in this review. Further research is necessary for the confirmation of these findings and for the evaluation of its use for other organisms of significance to hospital epidemiology.