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?aureus with succession scores >1.45. For the same samples incubated in BA medium, only four isolates were identified with scores >1.9, 11 with scores >1.7, and two with scores >1.45 where four identical and successive species were proposed. The difference between scores for the two culture conditions was statistically significant (Student��s t-test, p?[http://www.selleckchem.com/PI3K.html check details] gel, or because the separator gel did not adhere sufficiently to the tubes. Various Streptococcus species were also detected (65/73) in this series: 36/37 Streptococcus pneumoniae, 12/12 Streptococcus disgalactiae, 10/10 Streptococcus pyogenes, 6/6 Streptococcus agalactiae, 1/1 Streptococcusanginosus, and 0/1 Streptococcus sanguinis. Streptococcus mitis (0/5) and Streptococcus oralis (0/1) were misidentified by this technique as Streptococcus pneumoniae. Enterococci were all correctly distinguished: 22/22 Enterococcus faecalis and 4/4 Enterococcus faecium. Gram-positive anaerobes in monomicrobial samples were only represented by unidentified Propionibacterium acnes (0/4). MALDI- BioTyper correctly identified 274/295 (92.88%) Gram-positive bacteria. Thus, 95.22% of monomicrobial isolates were identified in these 482 samples. Most of the poorly identified Gram-positive [http://www.selleckchem.com/products/ch5424802.html Alectinib] bacteria belonged to CoNS and to Streptococcus (seven and ten isolates, respectively). Twenty-one polymicrobial samples generated 50 isolates by routine classical identification (Table?2). MALDI-TOF?MS identification used the same procedure, but bacteria were identified by considering the ten identification proposals provided by Biotyper. In fact, polymicrobial samples were suspected when MALDI BioTyper proposed two alternative species that were identified with score values >1.7. Table?3 shows that, for samples containing two or [http://en.wikipedia.org/wiki/Tryptophan_synthase Tryptophan synthase] more species, BioTyper identification may give iterated, but mixed, proposals of two distinct species, but with significant scores presumably according to the relative abundance of each bacterium. For such cases, BioTyper allows the superimposition and comparison of the sample spectrum with library spectra (Fig.?1). It is then possible to further analyse the different proposals. Among polymicrobial samples, 15 had two growing species identified with standard methods (Table?2). For these samples, MS identified one species in 12 of the cases. For eight of these samples, scores were >1.9, two others were correctly identified with a >1.7 score, and two were identified with a >1.4 score. However, two bimicrobial samples gave correct identification of three bacteria at scores