Evidence map›Paper›PMID 41571949›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2026

Direct identification and susceptibility testing of positive blood cultures: a large-scale evaluation of an ammonium chloride-based in-house workflow.

Xiaoli Zhang, Enhua Sun, Yixuan Qu, Yiwen Gao, Fuyao Hu, Weiwei Sun, Wei Li, Hongwei Pan

Abstract readEvaluation Study
PubMed Publisher
In one paragraph

Article 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. A review of bloodstream infections-pathogens, pathogenesis, diagnostic strategies, treatment methods-challenges and future aspects.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Review
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.

Xiaoli ZhangDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
Enhua SunDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
Yixuan QuDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
Yiwen GaoDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
Fuyao HuDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
Weiwei SunDepartment of clinical Laboratory, Jinan hospital, Jinan, 250013, China.
Wei LiDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China.
Hongwei PanDepartment of Clinical Laboratory, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong Province, China. panhongwei2018@sdu.edu.cn.

Funding

Natural Science Foundation of Shandong Province, China ZR2023MH123
6 · The paper itself

Abstract

purposePreviously, we reported an ammonium chloride-based in-house rapid workflow for direct pathogen identification and antibiotic susceptibility testing from positive blood cultures, eliminating the need for the following overnight subculture. Here, we aimed to assess the workflow’s reliability, accuracy, and potential for integration into routine clinical practice.

methodsFrom 2018 to 2022, 1,686 monomicrobial positive blood cultures were processed by the rapid workflow: ammonium chloride lysis/centrifugation/wash followed by MALDI-TOF MS identification and, when indicated, same-day VITEK-2 direct antibiotic susceptibility testing. Results were compared with routine culture-based identification and antibiotic susceptibility testing.

resultsThe overall agreement between in-house rapid workflow and conventional culture-based methods was 92.59%. Direct antibiotic susceptibility testing using VITEK 2 on 384 gram-negative and 126 gram-positive isolates showed very major, major, and minor error rates of 0.02%, 0.02%, and 1.14% for gram-negative bacteria, and 0.77%, 0.51%, and 1.09% for gram-positive bacteria. In addition, our IH rapid workflow significantly decreased 22.97 h to pathogen identification and 25.3 h to AST results.

conclusionOver five years, our in-house rapid workflow demonstrated reliable performance for pathogen direct identification and antibiotic susceptibility testing from positive blood cultures. The findings suggest that our rapid workflow has the potential to replace the subculturing of positive blood culture isolates to agar plates for definitive identification and antibiotic susceptibility testing. This could be a significant step forward in improving the efficiency and effectiveness of diagnosing and treating bloodstream infections.

Indexed as

Ammonium ChlorideAnti-Bacterial AgentsBacteremiaBacteriaBlood CultureGram-Negative BacteriaGram-Positive BacteriaWorkflowHumansMicrobial Sensitivity TestsReproducibility of ResultsSpectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationAmmonium ChlorideAnti-Bacterial AgentsAntibiotic susceptibility testingBloodstream infectionsIdentificationIn-house developed workflow

Identifiers

PMID41571949

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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 OpenQuestion graph.