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Clinical comparison of the AutoMicrobic system gram-positive identification card, API Staph-Ident, and conventional methods in the identification of coagulase-negative Staphylococcus spp.

In an effort to rapidly identify coagulase-negative staphylococci (CNS), a clinical comparison was conducted with the AutoMicrobic system Gram-Positive Identification Card (GPI) (Vitek Systems, Inc.), the API Staph-Ident (Analytab Products), and the conventional methods of W. E. Kloos and K. H. Schleifer (W. E. Kloos and K. H. Schleifer, J. Clin. Microbiol. 1:82-88, 1975). CNS isolates tested included 157 from blood and 33 from urine in pure culture at greater than 10(5) CFU/ml. S. epidermidis accounted for 79.6 and 60.6% of the isolates from blood and urine, respectively. S. saprophyticus was the next most frequent urine isolate (27.4%). Other CNS species were isolated from blood and urine specimens with frequencies of less than 5%. Overall, the GPI correctly identified 158 (83.2%) of the 190 CNS, whereas the Staph-Ident identified 124 (65.3%) without further testing. This resulted in the GPI and Staph-Ident correctly identifying 95.9 and 74.5% of the S. epidermidis and 100 and 33% of the S. saprophyticus, respectively. The GPI misidentified 8 (47%) of the S. hominis and S. warneri isolates as S. saprophyticus, indicating the need for novobiocin testing. These data suggest that the GPI is a more definitive method for the rapid identification of S. epidermidis than the Staph-Ident and that both systems require additional testing to identify S. saprophyticus.

Bacteriological Techniques

Use of the API NeIdent system for identification of pathogenic Neisseria spp. and Branhamella catarrhalis.

The API NeIdent system (Analytab Products, Plainview, N.Y.) was evaluated for identifying Neisseria spp. and Branhamella catarrhalis commonly isolated from clinical specimens. The system identified 90% of 303 Neisseria gonorrhoeae isolates, 71% of 113 Neisseria meningitidis isolates, and 63% of 16 Neisseria lactamica isolates but failed to identify any of 22 B. catarrhalis isolates. Testing of gonococcal strains of various auxotypes revealed no relationship between nutritional requirements and NeIdent profile numbers. With the Neisseria species, interpretation of the cinnamaldehyde-coupled beta-naphthylamine reactions was difficult and resulted in profile numbers not listed in the Profile Register. Positive resazurin-glucose reactions resulted in unlisted numbers for all B. catarrhalis strains. Inconsistent results were also obtained when 62 N. gonorrhoeae isolates were tested more than once on the strip. In all cases, profile variability and failure to identify these organisms were related to the beta-naphthylamide substrate tests. Expansion of the data base and modification of the substrate formulations or their interpretive criteria may increase the reliability of the NeIdent system for identifying Neisseria spp. and B. catarrhalis.

Bacteriological Techniques

Evaluation of the 24-h API 20A anaerobe system for identification of Clostridium difficile.

Accurate identification of Clostridium difficile is important when antibiotic-associated diarrhea or pseudomembranous colitis is suspected. Presumptive identification of C. difficile was made on the basis of microscopic features and colony characteristics on cycloserine, cefoxitin, fructose, and egg yolk agar medium. We studied the reliability of the 24-h API 20A anaerobe system for definitive identification of C. difficile. This system showed low dependability after the recommended 24 h of incubation by confirming the identity of only 54% of the isolates presumptively identified as C. difficile. There was a marked improvement in the system's capability after 48 h of incubation, when the identity of 95% of the isolates was confirmed.

Anaerobiosis

Comparative evaluation of the API 20S and AutoMicrobic gram-positive identification systems for non-beta-hemolytic streptococci and aerococci.

The API 20S system (Analytab Products, Plainview, N.Y.) and the AutoMicrobic Gram-Positive Identification system (GPI; Vitek Systems, Hazelwood, Mo.) were evaluated for their capacity to identify the non-beta-hemolytic streptococci and aerococci to the species level. The 20S system identified 86% (six of seven strains) of nonhemolytic group B streptococci, whereas 100% of the same group B streptococcal strains were correctly identified by the GPI system. With both systems 99% (134 of 135 strains) of four species of group D enterococcus strains and 92% (24 of 26 strains) of the Aerococcus spp. strains were identified. The 20S system identified 84% (41 of 49 strains) of three species of group D non-enterococcus strains. The GPI system identified 96% of the same group D non-enterococcus strains. The 20S system identified 84% (190 of 226 strains) of 10 species of viridans streptococci; however, supplemental conventional tests were required to identify 49% (110 of the 226 strains) of the viridans strains to the species level. The GPI system identified 79% of the same viridans streptococci without the need for supplemental tests. Both systems identified 84% (161 of 192 strains) of the seven most commonly occurring viridans Streptococcus spp. The 20S system identified 82% (75 of 92 strains) and the GPI system identified 84% (54 of 64 strains) of Streptococcus pneumoniae.

Bacteriological Techniques

Supplementary rapid biochemical test panel for the API 20E bacterial identification system.

The API 20E Analytical Profile Index typically suggests three or four conventional biochemical tests to complete the identification of strains either identified to genus only or that have multiple genera consistent with the profile number. We compiled a simple panel of eight rapid (4-h) tests that can substitute for the supplementary biochemical tests recommended by Analytab Products (Plainview, N.Y.). The rapid test panel (RTP) consisted of adonitol, cellobiose, lactose, raffinose, rhamnose, and xylose utilization, lysine decarboxylase activity, and motility. A total of 114 consecutive clinical isolates that required additional tests to complete the identifications were each tested with the complete RTP, as well as with the recommended conventional biochemicals. All discordant identifications were resolved by using an expanded series of conventional biochemical tests. Overall, 110 (96%) strains were identified to the correct genus, and 109 (95%) strains were identified to the correct species by using the RTP, as compared with 105 (92%) identified to the correct genus and 90 (79%) identified to the correct species with the recommended tests. The identifications based on the two supplementary test systems did not agree for 7 (6.1%) strains. Four discrepancies were resolved in favor of the RTP, and three were resolved in favor of the recommended tests. We were unable to identify five (4.4%) strains with the recommended tests and only one (0.9%) with the RTP. A majority (86%) of the test strains were identified to the species level with the RTP after only 4 h of incubation.

Bacteriological Techniques

Enzymatic characterization of Pseudomonas cepacia by API ZYM profile.

The enzymatic activities of 53 strains of Pseudomonas cepacia were determined by using the API ZYM system. Strong alkaline phosphatase, acid phosphatase, butyrate esterase, caprylate esterase, myristate lipase, leucine arylamidase, and phosphoamidase activities were consistently detected in all strains. Weak activities were observed for valine arylamidase, beta-glucosidase, and N-acetyl-beta-glucosaminidase. No activities could be demonstrated for cystine arylamidase, trypsin, chymotrypsin, alpha-galactosidase, beta-galactosidase, beta-glucuronidase, alpha-glucosidase, alpha-mannosidase, and alpha-fucosidase. Enzymatic activities of pseudomonads may provide useful information about their pathogenesis and information for identification of Pseudomonas species.

Chromogenic Compounds

Identification of Yersinia species by the API 20E.

A prospective study was performed to assess the effectiveness of the API 20E in the identification of 183 Yersinia isolates incubated at 28 degrees C for 18 to 24 h. The results showed an overall correct-identification rate of 90%, with positive predictive values for Yersinia enterocolitica and Yersinia frederiksenii of 94 and 92%, respectively. Yersinia intermedia results were unacceptable.

Bacteriological Techniques

Comparison of Vitek Gram-Positive Identification system with API Staph-Trac system for species identification of staphylococci of bovine origin.

Staphylococci (n = 130) of bovine origin representing 14 species were evaluated. Agreements of Vitek and API systems with conventional methods were 44.6 and 80.8%, respectively. The poor performance of the Vitek system was attributed primarily to inability to identify S. chromogenes. Incorporation of additional veterinary strains into the Vitek data base is needed to increase accuracy.

Animals

Evaluation of the API Coryne system for identification of Listeria species.

The API Coryne system, a commercially available system for the identification of coryneform bacteria, was used to identify 103 strains of Listeria spp. from clinical and environmental sources. All isolates were identified correctly to the genus or species level, although complete characterization also required tests for beta-hemolysis and CAMP reaction.

Listeria

Evaluation of media for determining hemolytic activity and that of API Listeria system for identifying strains of Listeria monocytogenes.

Several media were used to evaluate the hemolytic activity of Listeria monocytogenes, and this property was used along with the API Listeria system to identify Listeria spp. All L. monocytogenes strains were identified correctly with this system, and blood agar base no. 2 and Columbia blood agar base supplemented with horse blood were suitable for detection of hemolytic activity.

Agar

Inoculation of API-20E from positive blood cultures.

The API-20E system (Analytab Products, Inc., Plainview, N. Y.) was inoculated from 4- to 6-h tryptic soy broth cultures that had been inoculated from positive blood cultures containing gram-negative bacilli. This method gave the same genus and species identification for 139 of 140 organisms (47 patient and 96 simulated positive cultures) when compared to the Analytab Products, Inc., recommended method of inoculation.

Bacterial Infections

Standardization of the Analytab Enteric (API 20E) system to increase accuracy and reproducibility of the test for biotype characterization of bacteria.

Procedures employing the Analytab Enteric (API 20E) system were standardized to improve the accuracy and reproducibility of the individual biochemical tests so that the system could be used to biochemically characterize bacteria for epidemiological studies. The standardized method and the method recommended by the manufacturer (routine method) were tested in parallel with 130 clinical isolates. Tests with 100 randomly selected clinical isolates demonstrated that the standardized method was more accurate and reproducible than the routine method. In addition, the standardized method accurately identified 24 of 30 clinical isolates which could not be identified with the routine method.

Bacteriological Techniques

Comparison of Micro-ID and API 20E systems for identification of Enterobacteriaceae.

The Micro-ID 4-h identification system for Enterobacteriaceae was compared to the API 20E overnight method, using 230 fresh clinical isolates and 74 stock cultures. Agreement was 97.8% for the clinical isolates and 93.2% for the stock cultures. Eighty-seven percent of primary culture plates containing gram-negative rods yielded sufficient growth to perform the 4-h Micro-ID identification on the same day the organisms were isolated.

Bacteriological Techniques

Test reproducibility of the API (20E), Enterotube, and Pathotec systems.

Thirty-three strains of bacteria (30 Enterobacteriaceae and one strain each of Aeromonas formicans, A. hydrophila, and Plesiomonas shigelloides) were tested three times in each of 27 conventional tests and in the API, Enterotube, and Pathotec systems. The results obtained were analysed for test reproducibility within each kit, correlation of the kit tests with the equivalent conventional media, and the identification of the strains by the kits. Difficulties in evaluation and comparison of identifications are discussed. A practical evaluation of the kits was also made.

Bacteriological Techniques

Use of the API-ZYM system in rapid identification of alpha and non-haemolytic streptococci.

The API-ZYM method of detecting enzymes was tested using 99 streptococci isolated from clinical material and 14 type species obtained from the National Collection of Type Cultures. We found the method easy and reliable. The results obtained indicate that this method could be a useful identification system in busy routine clinical laboratories.

Bacteriological Techniques

Evaluation of a micromethod gallery (API Staph) for the identification of staphylococci and micrococci.

A collection of 300 well-characterised strains of staphylococci and micrococci was examined by a commercially available gallery micromethod (API Staph). The results were compared with biotyping by conventional methods. The gallery micromethod broadly agreed with the biotyping scheme used but gave an identification from the index supplied in less than 30% of the trials. Reproducibility was better after 48 h incubation than after 24 h but was poor for the tests for phosphatase and acetoin. When compared with the results of conventional tests, the tests for acetoin, phosphatase and urea were unsatisfactory.

Bacteriological Techniques

Biotyping of Haemophilus using API 10S--an epidemiological tool?

One hundred and ninety-nine strains of Haemophilus isolates were biotyped by Kilian's method(1) and a modified API 10S strip and the results compared. One hundred percent correlation was found between the two systems. The ONPG test proved of value in differentiating between Haemophilus influenzae and Haemophilus parainfluenzae when there was growth factor disc failure.

Adolescent