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Journal of Clinical Microbiology, December 2000, p. 4586-4592, Vol. 38, No. 12
Department of Clinical Laboratory, Chiba
Children's Hospital, Chiba, 266-0007, Japan
Received 5 June 2000/Returned for modification 6 August
2000/Accepted 16 September 2000
The algorithm for a new identification system was designed on the
basis of colony color and morphology on CHROMagar Orientation medium in
conjunction with simple biochemical tests such as indole (IND), lysine
decarboxylase (LDC), and ornithine decarboxylase (ODC) utilization
tests with gram-negative bacilli isolated from urine samples as well as
pus, stool, and other clinical specimens by the following colony
characteristics, biochemical reactions, and serological results:
pinkish to red, IND positive (IND+), Escherichia
coli; metallic blue, IND+, LDC+, and ODC
negative (ODC
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Cost-Effective and Rapid Presumptive Identification of
Gram-Negative Bacilli in Routine Urine, Pus, and Stool Cultures:
Evaluation of the Use of CHROMagar Orientation Medium in Conjunction
with Simple Biochemical Tests
), Klebsiella oxytoca;
IND+, LDC
, and ODC+,
Citrobacter diversus; IND+ or
IND
, LDC
, and ODC
,
Citrobacter freundii; IND
, LDC+,
and ODC+, Enterobacter aerogenes;
IND
, LDC
, and ODC+,
Enterobacter cloacae; IND
, LDC+,
and ODC
, Klebsiella pneumoniae; diffuse brown
and IND+, Morganella morganii;
IND
, Proteus mirabilis; aqua blue,
Serratia marcescens; bluish green and IND+,
Proteus vulgaris; transparent yellow-green, serology
positive, Pseudomonas aeruginosa; clear and serology
positive, Salmonella sp.; other colors and reactions, the
organism was identified by the full identification methods. The
accuracy and cost-effectiveness of this new system were prospectively
evaluated. During an 8-month period, a total of 345 specimens yielded
one or more gram-negative bacilli. A total of 472 gram-negative
bacillus isolates were detected on CHROMagar Orientation medium. For
466 of the isolates (98.7%), no discrepancies in the results were
obtained on the basis of the identification algorithm. The cost of
identification of gram-negative bacilli during this period was reduced
by about 70%. The results of this trial for the differentiation of the
most commonly encountered gram-negative pathogens in clinical specimens
with the new algorithm were favourable in that it permitted reliable
detection and presumptive identification. In addition, this rapid
identification system not only significantly reduced costs but it also
improved the daily work flow within the clinical microbiology laboratory.
*
Mailing address: Department of Clinical Laboratory,
Chiba Children's Hospital, Heta-cho, Midori-ku, Chiba, 266-0007, Japan. Phone: 81-43-292-2111. Fax: 81-43-292-3815. E-mail:
okiyo{at}apricot.ocn.ne.jp.
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