In recent years, the appearance of MALDI-TOF MS made it possible to identify bacterial species in a short time. However, the sensitivity test has not largely shortened the time. When ESBL is suspected by routine examination, we speculate that there are many institutions conducting the inspection method conforming to the CLSI inspection procedure. When carrying out bacteria identification, susceptibility test and ESBL confirmation test from blood culture-positive specimens, the expected examination days are required for about 3 to 4 days, which is not quick. We report on bacterial species identification by MALDI-TOF MS from blood culture positive specimen bottle and ESBL rapid decision with fully automated urine analyzer.