Evidence map›Paper›PMID 41467935›Full record

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.

Chen Peng, Jie Hou, Xin Li, Ao Deng, Ze-Hao Wang, Xue-An Wang, Bin Yang, Li-Sha Luo

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In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Chen PengDepartment of Laboratory Medicine, West China Tianfu Hospital of Sichuan University, Chengdu, China.
Jie HouDepartment of Laboratory Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, China.
Xin LiDepartment of Laboratory Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, China.
Ao DengDepartment of Laboratory Medicine, West China Tianfu Hospital of Sichuan University, Chengdu, China.
Ze-Hao WangDepartment of Laboratory Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, China.
Xue-An WangDepartment of Laboratory Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, China.
Bin YangDepartment of Laboratory Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Road, Wuhou District, Chengdu, 610041, Sichuan, China. yangbinhx@scu.edu.cn.
Li-Sha LuoDepartment of Pathology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610031, China. luolisha1995@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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

BacteremiaBacteriaBody FluidsSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationFungiHumansSensitivity and SpecificityBlood culture samplesDirect MALDI-TOF MSSterile body fluids

Identifiers

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.