FIG 1.

Bloodstream infection diagnostic workflow using direct (MALDI-TOF MS [MALDI BioTyper system] and/or FilmArray BCID panel) or culture-based (reference) microbial identification methods on positive blood culture (BC) broths. According to the developed algorithm, the FilmArray BCID panel assays were performed on BC broths that revealed multiple morphologies by Gram staining and in all cases for which MALDI BioTyper analysis failed to provide reliable results (i.e., identifications with scores of <1.8, multiple hits in the top 10 matches list with scores ranging from >1.7 to <1.8 that were suggestive of the presence of >1 microbial species, and identifications of organisms, such as S. pneumoniae). MALDI-TOF MS, matrix-assisted laser desorption ionization–time of flight mass spectrometry; BCID, blood culture identification.