Comparative Evaluation of Five Chromogenic Media for Detection, Enumeration and Identification of Urinary Tract Pathogens

Carricajo, Anne; Boiste, S; Thore, J; Aubert, G.; Gille, Y.; Freydière, Anne-Marie

doi:10.1007/s100960050403

Cited by 36 publications

(34 citation statements)

References 16 publications

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“…Several researchers - Aspell et al, (2002), Carricajo et al, (1999), and Scarparo et al, (2002), have previously demonstrated equal or superior performance of various chromogenic media over traditional media for identification of urinary tract pathogens. Table 5 shows the rate of presumptive identification of isolated organisms.…”

Section: Resultsmentioning

confidence: 99%

A Study on Evaluation of Different Culture Media for the Isolation of Routine Urinary Pathogens

Manjusree¹,

Sasikumari²,

Bai³

2017

Int.J.Curr.Microbiol.App.Sci

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Section: Resultsmentioning

confidence: 99%

A Study on Evaluation of Different Culture Media for the Isolation of Routine Urinary Pathogens

Manjusree¹,

Sasikumari²,

Bai³

2017

Int.J.Curr.Microbiol.App.Sci

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“…Although screening methods have been studied exhaustively, none has been universally accepted, especially for the complex microbiology of cultures from institutionalized patients (3, 17). Chromogenic agars have recently been developed to facilitate recognition of species directly on primary media (1,4,5,7,9,16,18,19,20). CHROMagar Candida (Becton Dickinson Microbiology Products [BD], Cockeysville, Md.)…”

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confidence: 99%

Practical Bench Comparison of BBL CHROMagar Orientation and Standard Two-Plate Media for Urine Cultures

D’Souza¹,

Campbell

Baron³

2004

J Clin Microbiol

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A total of 1,023 urine samples sent for routine culture were plated onto sheep blood and MacConkey agars and a BBL CHROMagar Orientation (CO; Becton Dickinson, Cockeysville, Md.) plate, and the results were compared. Of these, 250 urine samples (24%) grew >10,000 CFU of one or two putative pathogens/ml and 773 showed no growth (NG), mixed growth of <10,000 CFU/ml, or three or more strains (mixed). The CO and conventional medium results agreed completely for 595 cultures with NG or <10,000 CFU/ml. An additional 178 urine samples yielded clinically insignificant differences. Both medium sets essentially agreed on quantities and identification for 400 single-pathogen cultures and 9 mixed cultures. With the caveat that CO cannot differentiate Klebsiella, Enterobacter, and Serratia spp., enteric pathogens were identified only by morphology and color on CO. Direct visual differentiation of group B streptococci from lactobacilli is not possible, but lactobacillus cells always exhibited easily recognizable morphology on Gram stain. Of 108 paired organism susceptibility results encompassing 2,268 drug-pathogen combinations, there were 3% errors and only 1% very major errors. Use of CO allowed a >50% reduction in inoculation time and a >20% reduction in work-up time. For our laboratory, with 50% "no growth" and ca. 25% significant results (50% Escherichia coli), CO allowed time and workup cost savings for a majority of cultures. A cost analysis (time and supplies for our laboratory) showed that if CO is used alone, the break-even level for CO pricing is $1.78; if CO and blood agar are both used, the break-even pricing for CO is $1.53.Urine samples are among the most numerous of specimen types sent for microbiology studies. The labor expended in the workup of mixed cultures, which may not be clinically relevant, and the fact that many clinicians treat urinary tract infections (UTI) empirically have prompted many laboratories to explore methods to limit the time and expense of urine culture processing (6). Although screening methods have been studied exhaustively, none has been universally accepted, especially for the complex microbiology of cultures from institutionalized patients (3, 17). Chromogenic agars have recently been developed to facilitate recognition of species directly on primary media (1,4,5,7,9,16,18,19,20). CHROMagar Candida (Becton Dickinson Microbiology Products [BD], Cockeysville, Md.) has been widely adopted, including in our laboratory, and several studies have indicated its utility (8,10,14,15,18). Given our positive experience with CHROMagar Candida, we sought to evaluate CHROMagar Orientation (CO [BD]), a modification of a chromogenic agar developed for urine cultures, in a routine laboratory setting (7, 16). We compared culture results and the ability to perform automated antimicrobial susceptibility testing directly from the original CO plate, and we did a cost comparison (time and materials) with our standard two-plate method for routine urine cultures. MATERIALS AND METHODSSpecimen handling and ...

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“…In one study, no significant differences between the isolation rates of different chromogenic media were found (2).…”

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Performance of Four Chromogenic Urine Culture Media after One or Two Days of Incubation Compared with Reference Media

et al. 2002

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Four chromogenic urine culture media were compared to culture on blood agar, MacConkey agar, and CLED (cysteine-, lactose-, and electrolyte-deficient) agar for detection of uropathogens in 1,200 urine specimens. After 2 nights of incubation, 96% of all isolates were recovered on blood agar, 96% were recovered on CLED agar, 92% were recovered on CPS ID2, 96% were recovered on CHROMagar Orientation from BBL, 95% were recovered on CHROMagar Orientation from The CHROMagar Company, and 95% were recovered on Chromogenic UTI Medium.Chromogenic media have been compared to traditional urine culture media, e.g., blood agar and MacConkey agar, and been found to be at least as good as traditional media for the isolation of uropathogens (7,9,12,13). In one study, no significant differences between the isolation rates of different chromogenic media were found (2).Three articles reported the effect of incubation time on results of urine culture on traditional media (3,8,11). All agree that common uropathogens can be detected after overnight incubation and that a longer incubation time is required for the detection of yeasts.In this study, we evaluated four different chromogenic agars Blood agar, CLED (cysteine-, lactose-, and electrolyte-deficient) agar, and MacConkey agar were used as the reference media. We also compared overnight incubation to 2 nights of incubation; to our knowledge, this has not been done previously.The media evaluated are listed in Table 1. Blood agar, CLED agar, MacConkey agar, CHROMagar Orientation from The CHROMagar Company, and Chromogenic UTI Medium were prepared at the respective laboratories in accordance with the manufacturers' recommendations.CPS ID2 and CHROMagar Orientation from BBL were received as ready-made agar plates. Media prepared at the laboratories were tested for contamination by incubation of one plate from each batch at room temperature and one plate in ambient atmosphere at 36°C for 2 days.Each batch was also tested for typical colony appearance and growth with Enterococcus faecalis ATCC 29212, Staphylococcus aureus ATCC 25923, Escherichia coli ATCC 25922, Klebsiella pneumoniae ATCC 13883, and Proteus mirabilis ATCC 29245.The media were compared by using quantitative culture with test strains. In this comparison, 10-l volumes of serial dilutions (starting from approximately 10 8 CFU/ml) of each test strain (E. coli ATCC 25922, E. faecalis ATCC 29212, and S. saprophyticus ATCC 15305) were inoculated onto each medium with a calibrated pipette (Finnpipette; Labsystems). Colonies were counted after 1 and 2 days of incubation in ambient atmosphere at 36°C.The media were also evaluated by using urine specimens sent in for routine culture. The first 50 urine specimens that arrived every day at each laboratory were included in the study. A total of 1,200 urine specimens were inoculated on all of the media tested. The laboratories serve both tertiary care hospitals and primary care centers. Most of the specimens included in the study were from inpatients, as the specimens collected at the ...

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Comparative Evaluation of Five Chromogenic Media for Detection, Enumeration and Identification of Urinary Tract Pathogens

Cited by 36 publications

References 16 publications

A Study on Evaluation of Different Culture Media for the Isolation of Routine Urinary Pathogens

A Study on Evaluation of Different Culture Media for the Isolation of Routine Urinary Pathogens

Practical Bench Comparison of BBL CHROMagar Orientation and Standard Two-Plate Media for Urine Cultures

Performance of Four Chromogenic Urine Culture Media after One or Two Days of Incubation Compared with Reference Media

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