ReviewEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026
Clinical application of MALDI-TOF MS for direct and rapid pathogen identification: a comprehensive review focusing on bloodstream infections and sterile body fluids.
Review in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Simultaneous visual diagnosis of capsulated and non-capsulated Haemophilus influenzae using a duplex RPA method.Archives of microbiology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis review critically evaluates the performance of direct matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for rapid pathogen identification in life-threatening infections. It aims to assess its application directly from positive blood cultures and sterile body fluids, examine the factors influencing identification success rates, and identify the key challenges limiting its broader clinical implementation.
methodsA review of the literature was conducted, focusing on studies utilizing commercial kits or optimized laboratory protocols for direct testing from clinical specimens, including positive blood cultures, cerebrospinal fluid, urine, and enrichment cultures from synovial fluid and ascites.
resultsDirect MALDI-TOF MS can deliver reliable pathogen identification within 30–60 minutes, significantly shortening diagnostic turnaround time. However, identification success is not uniform; a consistent performance gradient is observed, with Gram-negative bacteria identified more successfully than Gram-positive bacteria and fungi. This variability reflects differences in microbial cell structure and protein extraction efficiency. Major constraints include limited sensitivity in paucibacterial samples, spectral interference from host matrices, difficulties in diagnosing polymicrobial infections, and gaps in reference databases for emerging pathogens.
conclusionDirect MALDI-TOF MS is a transformative tool for rapid infection diagnosis. To fully realize its potential in routine practice, future advancements must integrate automated sample processing, enhance sensitivity via techniques like MALDI-2, and employ artificial intelligence for spectral analysis and resistance prediction. Overcoming these barriers will establish this technology as a cornerstone of rapid diagnostic pathways, improving patient outcomes and supporting antimicrobial stewardship.
Indexed as
Identifiers
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Registered trials
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