Fast and accurate detection of causative agents of bloodstream infections remains a challenge of today's microbiology. We compared the performance of cutting-edge technology based on polymerase chain reaction coupled with electrospray ionization-mass spectrometry (PCR/ESI-MS) with that of conventional broad-range 16S rRNA PCR and blood culture to address the current diagnostic possibilities for bloodstream infections. Of 160 blood samples tested, PCR/ESI-MS revealed clinically meaningful microbiological agents in 47 samples that were missed by conventional diagnostic approaches (29.4% of all analyzed samples). Notably, PCR/ESI-MS shortened the time to positivity of the blood culture-positive samples by an average of 34 hr. PCR/ESI-MS technology substantially improved current diagnostic tools and represented an opportunity to make bloodstream infections diagnostics sensitive, accurate, and timely with a broad spectrum of microorganisms covered.

3rd Department of Surgery 1st Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Department of Anaesthesiology and Intensive Care Medicine 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Department of Clinical Microbiology Rigshospitalet Copenhagen Denmark

Department of Medical Microbiology 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

National Institute for Infectious Diseases University of Medicine and Pharmacy Carol Davila Bucharest Romania

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