The low rate of VGS and enterobacteriaceae sepsis was probably due to the effective decontamination. Our supportive care strategy could potentially help enhance overall survival in children with AML.

API NH is a new 2-h system (bioMerieux, La Balme-les-Grottes, France) for the identification of most Neisseria and Haemophilus spp. of clinical significance and of MoraxeUa catarrhalis and for the detection of penicillinase production. Furthermore, this system allows the biotyping of Haemophilus influenzae and Haemophilusparainfluenzae. Three hundred eighteen strains belonging to these species, previously identified by conventional methods, were tested. Among the 305 strains belonging to species included in the data base, 225 (73.8%) were identified without additional tests, 79 (25.91%) were correctly identified after extra tests, and 1 strain (0.3%) was misidentified. For 131 (90.3%) of the 145 H. influenzae and H. parainfluenzae strains, results of biotyping were in agreement with results of standard methods. API NH is an accurate and reliable method for the routine identification of these bacteria in a clinical laboratory, for biotyping ofHaemophils spp., and for the detection of penicillinase-producing strains. The system is ready to use and time saving-, inoculation of the system and reading of results are easy. Members of the genus Haemophilus are obligate parasites that constitute part of the normal flora of the human respiratory tract. In some cases, Haemophilus spp., mainly Haemophilus influenzae, may be responsible for various suppurative diseases (9). Of the members of the genus Neisseria, Neisseria meningitidis and Neisseria gonorrhoeae are the only species recognized as primary pathogens, while the other Neisseria spp. as well as Moraxella catarrhalis are either commensal or opportunistic pathogens (3, 10). The conventional means of identifying these bacteria are based on the use of selective and/or enriched media and nutritional requirements, in addition to biochemical tests. These methods are actually time-consuming and tedious. The present study was carried out to evaluate the new API NH system (bioMerieux, La Balme-les-Grottes, France) for the identification of Haemophilus and Neisseria spp. as well as M. catarrhalis, for the biotyping of Haemophilus spp., and for the detection of penicillinase production. MATERIALS AND METHODS Bacteria. The study was carried out on 318 strains belonging to the genera Haemophilus, Neisseria, and Moraxella, including 120 recent clinical isolates, 178 stock strains of clinical origin, and 20 reference strains. The strains were grown in a CO2 incubator for 24 h at 37C on chocolate agar supplemented with PolyVitex (bioMerieux). Conventional identification. The following characteristics were determined for each strain: Gram staining, oxidase, catalase, and hemolysis. The Haenophilus strains were identified according to their X and V factor requirements (9). Biotyping was performed with an API 20E strip (bio-Merieux) as described by Holmes et al.

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Three serological methods for streptococci grouping: latex agglutination after pronase extraction (LAP), latex agglutination after nitrous acid extraction (LAN) and counterimmunoelectrophoresis after nitrous acid extraction (CIEN) were evaluated in six laboratories with 310 strains of streptococci. To reduce the possible influence of a particular laboratory, each serological procedure was performed in two different laboratories with identical protocols and strains. Between the three procedures, a total agreement of 81.3% with six identical results was obtained. Since only one discordant result was obtained in 12.2% (CIEN 4.8%-LAN 5.8%-LAP 1.6%) and two discordant results with two different serological methods in 2.6%, it could be concluded that agreement between the three procedures was 96%. For B (99 strains tested) and D(100 strains tested) groups, total agreements of respectively 95% and 92% were achieved. In conclusion, LAP, LAN, and CIEN gave equivalent results for streptococci grouping, but LAN was the most simple needing no heating, centrifugation, or electrophoresis equipment and lacking cross-reactivity of group C antibody.

CorrespondenceEur. J. Clin. Microbiol.identification of the bacteria with satisfactory sensitivity and specificity. However, results still require confirmation by culture.