Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) is a rapid method for the identification of bacteria. Factors that may alter protein profiles, including growth conditions and presence of exogenous substances, could hinder identification. Bacterial isolates identified by conventional methods were grown on various media and identified using the MALDI Biotyper (Bruker Daltonics, Billerica, MA) using a direct smear method and an acid extraction method. Specimens included 23 Pseudomonas isolates grown on blood agar, Pseudocel (CET), and MacConkey agar (MAC); 20 Staphylococcus isolates grown on blood agar, colistin-nalidixic acid agar (CNA), and mannitol salt agar (MSA); and 25 enteric isolates grown on blood agar, xylose lysine deoxycholate agar (XLD), Hektoen enteric agar (HE), salmonella-shigella agar (SS), and MAC. For Pseudomonas spp., the identification rate to genus using the direct method was 83% from blood, 78% from MAC, and 94% from CET. For Staphylococcus isolates, the identification rate to genus using the direct method was 95% from blood, 75% from CNA, and 95% from MSA. For enteric isolates, the identification rate to genus using the direct method was 100% from blood, 100% from MAC, 100% from XLD, 92% from HE, and 87% from SS. Extraction enhanced identification rates. The direct method of MALDI-TOF analysis of bacteria from selective and differential media yields identifications of varied confidence. Notably, Staphylococci spp. from CNA exhibit low identification rates. Extraction enhances identification rates and is recommended for colonies from this medium. P rompt and accurate identification of bacterial isolates is an objective of the clinical microbiology laboratory and is paramount for patient care. Conventionally this has been achieved using macro-and microscopic observation of morphology and biochemical analysis. These methods often require isolation of individual colonies from polymicrobial cultures and subculture prior to isolate identification. These steps can add significant time to identification of isolates. Molecular methods provide reliable results, though many are expensive to perform, time-consuming, and technically demanding (6). Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently emerged as a rapid, accurate, and cost-effective method of identification, applicable to a wide range of bacterial isolates (9,12,13,16,17,19).A major benefit of MALDI-TOF technology is the ability to obtain identifications using a single colony, eliminating the need for subculture and further incubation. To identify most isolates, a single colony can be picked from solid culture media using a swab or toothpick and smeared directly onto a polished steel target plate for identification (direct method) (1, 9, 14, 17, 18). Alternatively, isolates with formidable cell walls or those that produce excess exopolysaccharide matrix (i.e., mucoid pseudomonads) may require processing through a short (approximately 5-min) form...