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Journal of Clinical Microbiology, September 2000, p. 3394-3398, Vol. 38, No. 9
Department of Laboratory Medicine, University
of California, San Francisco, California 941431;
Department of Pathology, Stanford University Medical School,
Stanford, California 943052; Veterans
Administration Medical Center, Houston, Texas
770303; Department of Pathology and
Laboratory Medicine, Evanston Hospital, Evanston, Illinois
602014; and Departments of Medicine and
Pathology, Robert Wood Johnson Medical School, New Brunswick, New
Jersey 089015
Received 14 February 2000/Returned for modification 18 April
2000/Accepted 4 July 2000
To validate the accuracy of rapid tests for identification of
Escherichia coli, five laboratories sequentially collected
1,064 fresh, clinically significant strains with core criteria of
indole-positive, oxidase-negative, nonspreading organisms on sheep
blood agar plates (BAP), having typical gram-negative rod plate
morphology, defined as good growth on gram-negative rod-selective
media. An algorithm using beta-hemolysis on BAP, lactose reaction on
eosin-methylene blue or MacConkey agar,
L-pyrrolidonyl-
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Multilaboratory Validation of Rapid Spot Tests for
Identification of Escherichia coli
-naphthylamide (PYR), and
4-methylumbelliferyl-
-D-glucuronide (MUG) was evaluated. Identifications using the algorithm were compared to those obtained using commercial kit system identifications. One thousand strains were
E. coli and 64 were not E. coli by kit
identifications, which were supplemented with conventional biochemical
testing of low probability profiles. Of the 1,064 isolates meeting the
core criteria, 294 were beta-hemolytic and did not require further
testing to be identified as E. coli. None of the 64 non-E. coli strains were hemolytic, although other
indole-positive, lactose-negative species were found to be hemolytic
when further strains were examined in a follow-up study. Of the
remaining strains, 628 were identified as E. coli by a
lactose-positive and PYR-negative reaction. For nonhemolytic,
lactose-negative E. coli, PYR was not helpful, but a
positive MUG reaction identified 65 of 78 isolates as E. coli. The remaining 13 E. coli strains required kit
identifications. This scheme for E. coli identification
misidentified three non-E. coli strains as E. coli, for an error rate of 0.3%. A total of 13 kit
identifications, 657 PYR tests, and 113 MUG tests were needed to
identify 1,000 E. coli strains with the algorithm. The use
of this rapid system saves laboratory resources, provides timely
identifications, and yields rare misidentifications.
*
Corresponding author. Mailing address: Department of
Laboratory Medicine, L 515, Box 0100, University of California, San
Francisco, CA 94143. Phone: (415) 353-1268. Fax: (415) 353-1829. E-mail: MKYORK{at}WORLDNET.ATT.NET.
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