Identification of Candida Species from Clinical Isolates and Their Antifungal Susceptibility Pattern.

With increasing use of antibacterial and cytotoxic drugs, lethal invasive Candidiasis is on the rise, with almost half of the cases being caused by non albicans Candida species (NAC). Frequent use of azoles for empirical therapy has also led to their increased resistance. We wanted to characterise Candida species isolated from various clinical specimens and assess their susceptibility pattern to Fluconazole and Voriconazole.METHODSA total of 100 consecutive Candida species isolated from various clinical specimens in our institute from January 2016 to December 2016 were included in the study. Standard yeast identification protocol and CHROM agar were used for speciation and their antifungal susceptibility pattern was found by disc diffusion method.RESULTSOut of the 100 isolates, C. tropicalis was the predominant isolate (47%), followed by C. albicans (31%), C. parapsilosis (16%) and C. krusei (6%). Females (57%) were more affected and maximum number of patients was above 60 years (24%). Diabetes mellitus (21%) was the major predisposing factor for Candida, followed by broad spectrum antibiotic therapy (14%). Isolates were more susceptible to Voriconazole (99%) than Fluconazole (87%). NAC spp. showed more resistance to Fluconazole (17.4%) than C. albicans (3.3%). Only one isolate of C. krusei (16.6%) showed resistance to Voriconazole.CONCLUSIONSDue to the increasing incidence of azole resistant NAC spp., the species level identification of Candida species, along with their anti-fungal susceptibility patterns can help the clinicians in formulating a treatment protocol and can help in decreasing the mortality and morbidity.

CHROMagar Candida medium for identification of Candida species:a systematic review / 国际检验医学杂志

Objective To evaluate the accuracy of CHROMagar Candida medium in identifying common Candida species .Meth‐ods Articles were extensively collected by searching the databases of MEDLINE and EMBase ,the Chinese Biomedical Database (CBM ) ,the Chinese Scientific Journals Database (CSJD) ,the Chinese Journal Full Text Database (CJFD) and through other ways . The qualities of these articles were assessed by using the quality assessment of diagnostic accuracy studies(QUADAS) .At last , summary receiver operating characteristic (SROC) curve was performed by the Meta‐Disc software ,so as to summarize diagnostic accuracy of CHROMagar Candida medium in identifying common Candida species .Results A total of 7 articles meeting all criteria were enrolled in this study .All 7 articles reported the accuracy of CHROMagar Candida medium in identifying the Candida albi‐cans ,the pooled sensitivity and specificity was 98 .3% and 98 .8% respectively ,and area under SROC curve (AUC) was 0 .998 0 .A‐mong them ,6 articles reported the accuracy of CHROMagar Candida medium in identifying Candida tropicalis ,the pooled sensitivity and specificity was 92 .5% and 99 .8% respectively ,and the AUC was 0 .998 3 .Among them ,5 articles reported the accuracy of CHROMagar Candida medium in identifying Candida Glabrata ,the pooled sensitivity and specificity was 98 .3% and 98 .7% respec‐tively ,and the AUC was 0 .996 8 .Conclusion CHROMagar Candida medium could quickly identify clinical common Candida species and results are reliable .

Distribution of different yeasts isolates among trauma patients and comparison of accuracy in identification of yeasts by automated method versus conventional methods for better use in low resource countries.

Introduction: As most trauma patients require long‑term hospital stay and long‑term antibiotic therapy, the risk of fungal infections in such patients is steadily increasing. Early diagnosis and rapid treatment is life saving in such critically ill trauma patients. Aims: To see the distribution of various species of Candida among trauma patients and compare the accuracy, rapid identification and cost effectiveness between VITEK 2, CHROMagar and conventional methods. Settings and design: Retrospective laboratory‑based surveillance study performed over a period of 52 months (January 2009 to April 2013) at a level I trauma centre in New Delhi, India. Materials and Methods: All microbiological samples positive for Candida were processed for microbial identification using standard methods. Identification of Candida was done using chromogenic medium and by automated VITEK 2 Compact system and later confirmed using the conventional method. Time to identification in both was noted and accuracy compared with conventional method. Statistical analysis: Performed using the SPSS software for Windows (SPSS Inc. Chicago, IL, version 15.0). P values calculated using χ2 test for categorical variables. A P < 0.05 was considered significant. Results: Out of 445 yeasts isolates, Candida tropicalis (217, 49%) was the species that was maximally isolated. VITEK 2 was able to correctly identify 354 (79.5%) isolates but could not identify 48 (10.7%) isolates and wrongly identified or showed low discrimination in 43 (9.6%) isolates but CHROM agar correctly identified 381 (85.6%) isolates with 64 (14.4%) misidentification. Highest rate of misidentification was seen in C. tropicalis and C. glabrata (13, 27.1% each) by VITEK 2 and among C. albicans (9, 14%) by CHROMagar. Conclusions: Though CHROMagar gives identification at a lower cost compared with VITEK 2 and are more accurate, which is useful in low resource countries, its main drawback is the long duration taken for complete identification.

Chromogenic Tube Test for Presumptive Identification and Susceptibility Test of Candida Spp.

Chromagar Candida is a new, modified, simple, rapid and cost effective method for the presumptive identification of Candida spp. after preliminary growth. 54 randomly selected clinical isolates of Candida were evaluated including, C.albicans (24), C.tropicalis (13), C.parapsilosis (6), C.krusei (5) & C.glabrata (4). The sensitivity and specificity appeared to be equal to that of conventional identification system except 4 C.glabrata strains which could only be identified by conventional method. Terbinafine, amphotericin B and nystatin were found to be highly sensitive drugs and clotrimazole and fluconazole showed the worst sensitivity results.

Rapid Detection of Extended Spectrum Β-lactamase (ESBL) Producing Strain of Escherichia coli in Urinary Tract Infections Patients in Benha University Hospital, Egypt.

Background: An increase in extended spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) has been observed. Aims: Of this study was done to detect the prevelance of ESBL, AmpC producing and ESBL and AmpC co-producing strains of Escherichia coli (E. coli) in urinary tract infections patients in Benha University Hospital and to evaluate the performance of CHROMagar™ ESBL media for rapid screening of ESBL producing E. coli. Place and Duration of Study: This is a Six-months Cross sectional study conducted in Urology and Microbiology & Immunology departments, Benha University, Egypt. Methodology: All patients under study were subjected to: Full history taking and clinical examination. Bacteriological study included; urine sample collection from each patient and subjected to urine analysis, urine culture on cysteine lactose electrolyte deficient agar (CLED) agar, CHROMagar™ ESBL media and MacConkey agar supplemented with 2 mg/liter ceftazidime (MCKC). ESBL detection in E. coli isolated on CLED agar by phenotypic screening by clinical and laboratory standards institute (CLSI) method then phenotypic confirmation by E. test. The presence AmpC beta-lactamase ESBL was detected by AmpC disc test and detection of AmpC beta-lactamase and ESBL coproducers by cefepime and Cefepime + Clavulanate E test. Results: In this study out of 45 E. coli strains 24 (53.3%) ESBL producers were detected by E. test (golden method for confirmation of ESBL according to CLSI) and 21(46.7%) strains were non ESBL producers. There was no significant difference between ESBL isolation from community acquired and health care associated UTI patients; out of the 24 isolated ESBL producing E.coli strains 9 (37.5%) were detected in community acquired UTI patients while 15 (62.5%) were detected in health care associated UTI patients. The sensitivity of both MCKC and CHROMagar™ ESBL media were 100% (95%CL: 85.6% to 100%).While specificity were 87.5% (95%CL:67.6% to 97.2%) and 80.8% (95%CL: 60.6% to 93.4%) respectively. In our study out of 45 isolated E. coli strains 14 (31.1%) were AmpC producers by AmpC test, 4 (8.9%) were AmpC and ESBL co-producers by cefepime/ cefepime clavulanic E.test. Conclusion: It is important to know the prevalence of ESBL, AmpC producing and ESBL&AmpC co-producing organisms so that judicious use of antibiotics could be done and increase awareness about the need for routine detection of AmpC and ESBL in clinical isolates. CHROMagar™ ESBL media detect ESBL producers from clinical specimen and give rapid presumptive identification by means of colony colour after 24h with good sensitivity and specificity.

Evaluation on the capability of CHROMagar orientation medium combined with simple biochemical tests for identificaction of common oxidase-negtive gram-negative bacilli / 中华微生物学和免疫学杂志

Objective To evaluate the practicability of CHROMagar orientation medium combined with simple biochemical tests for identification of common oxidase-negtive gram-negative bacilli.Methods The CHROMagar orientation medium was used together with biochemical tests including indole test , ornithine decarboxylase test and lysine decarboxylase test for identification of common oxidase -negtive gram-negative bacilli.The sensitivity, specificity, likelihood ratio, Youden index and Kappa value of the diagnostic assays were evaluated .McNemar test was performed to evaluate facticity, accuracy and cost of the method in com-parison with the Vitek-2 system as reference method .Results The identification of oxidase-negtive gram-negative bacilli from 318 bacterial strains showed that the sensitivities and specificities of CHROMagar orien-tation mediumm in combination with simple biochemical tests to Serratia marcescens, Stenotrophomonas mal-tophilia and Acinetobacter baumannii reached 100%, and for Escherichia coli, Enterobacter aerogenes and Klebsiella pneumoiae were above 90%.The specificities for identification of Enterobacter cloacae, Klebsiella oxytoca, Citrobacter freundii and Proteus mirabilis were all above 90%, but the sensitivities were around 75%-90%.Kappa values of the assays were above 0.85, howerer, which was only 0.5947 for Citrobacter freundii.McNemar test showed that all P values were above 0.05, and cost of the assays was reduced by 90%.Conclusion CHROMagar orientation medium in combination with simple biochemical tests is a cost-effective assay for identification of common oxidase-negtive gram-negative bacilli .

Modified CHROMagar Acinetobacter Medium for Direct Detection of Multidrug-Resistant Acinetobacter Strains in Nasal and Rectal Swab Samples

This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37degrees C. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.

Modified CHROMagar Acinetobacter Medium for Direct Detection of Multidrug-Resistant Acinetobacter Strains in Nasal and Rectal Swab Samples

This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37degrees C. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.

Etiología de la candidiasis vulvovaginal recidivante en la Atención Primaria de Salud en Santa Catarina, Brasil / Etiology of recurrent vulvovaginal candidiasis in the National Health System in Santa Catarina, Brazil / Etiologia da candidíase vulvovaginal recorrente na Atenção Primária à Saúde em Santa Catarina, Brasil

El objetivo del presente trabajo fue destacar las características epidemiológicas que puedan subsidiar la Atención Primaria de Salud (APS) en mujeres portadoras de candidiasis vulvovaginal (CVV) y candidiasis vulvovaginal recidivante (CVVR), a partir de estudios realizados en tres municipios del sur de Brasil. A través del examen micológico de la secreción vaginal de 300 mujeres con sospecha clínica de CVV o CVVR se identificaron las especies prevalentes de Candida, correlacionándose los hallazgos con los principales factores de riesgo mencionados en la literatura. Fueron confirmadas levaduras en 90 (30%) casos, resultando las especies más frecuentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) y Candida spp. (11,1%). En los casos de CVVR, C. albicans fue la especie más encontrada, con una prevalencia superior a la observada en la CVV. C. krusei apareció como la segunda especie más prevalente en todas las muestras, resaltando la importancia del diagnóstico a nivel de especie, dada la resistencia intrínseca al fluconazol. Las informaciones epidemiológicas del estudio son útiles para que los gestores de la Atención Primaria de Salud (APS) y los profesionales de la Salud puedan tener subsidios adicionales para actuar preventivamente en el caso de candidiasis vulvovaginales.

The main purpose of this work was to highlight epidemiological characteristics serving as subsidies to health promotion activities for vulvovaginal candidiasis (VVC) and recurrent vulvovaginal candidiasis (RVVC) by the national health system, in three cities in southern Brazil. Through the mycological examination of vaginal secretions of 300 women with clinical suspicion of VVC or RVVC, Candida-prevalent species were identified and they were correlated with the main risk factors mentioned in the literature. Yeasts were confirmed in 90 (30%) cases, resulting in C. albicans 61.1%, C. krusei 16.7%, C. tropicalis 6.7%, C. glabrata 4.4% and others 11.1%. C. albicans was the species most commonly found in cases of RVVC, with levels higher than the prevalence of the species in the VVC. C. krusei prevailed as the second most prevalent species in both samples, emphasizing the importance of diagnosing the species level, due to its intrinsic resistance to fluconazole. The epidemiological information of the study is useful for managers of the National Health Care System, as well as direct health professionals, who can have new subsidies to act preventively against vulvovaginal candidiasis.

O objetivo do presente trabalho foi destacar as características epidemiológicas que possam subsidiar a Atenção Primária à Saúde (APS) em mulheres portadoras de candidíase vulvovaginal (CVV) e candidíase vulvovaginal recorrente (CVVR), a partir de estudos realizados em três municípios do sul do Brasil. Através do exame micológico da secreção vaginal de 300 mulheres com suspeita clínica de CVV ou CVVR foram identificadas as espécies prevalentes de Candida, correlacionando os achados com os principais fatores de risco mencionados na literatura. Foram detectadas leveduras em 90 (30%) dos casos, resultando as espécies mais frequentes C. albicans (61,1%), C. krusei (16,7%), C. tropicalis (6,7%), C. glabrata (4,4%) e Candida spp. (11,1%). Nos casos de CVVR, C. albicans foi a espécie mais encontrada, com uma prevalência superior à observada nos casos de CVV. C. krusei apareceu como a segunda espécie mais prevalente em todas as amostras, ressaltando a importância do diagnóstico em nível de espécie, devido à resistência intrínseca ao fluconazol. As informações epidemiológicas deste estudo são úteis para que os gestores da Atenção Primária à Saúde (APS) e os profissionais da Saúde Pública possam ter subsídios adicionais para atuar preventivamente nos casos de candidíases vulvovaginais.

Comparative study of Candida by conventional and CHROMagar method in non-denture and denture wearers by oral rinse technique.

Introduction: Candidal species colonizes the oral cavities of healthy individuals without dentures and also of denture wearers. Soft liners and tissue conditioning materials have been found to support the growth of Candida albicans which may predispose to lesions. The most important and common candidal species are C. albicans, C. tropicalis, and C. glabrata. C albicans is usually isolated from both the fitting surface of the denture and the denture-bearing mucosa of the affected patients. The aim of this study was to isolate, quantify, and speciate candidal species in non-denture wearers (controls) and denture wearers (study group) by the oral rinse technique. Isolation was done using Sabouraud dextrose agar (SDA). Speciation was done using conventional methods like the germ tube test, carbohydrate fermentation test, urease test, as well as the CHROMagar method. Aims and Objective: 1) To assess the prevalence of Candida in non-denture wearers and in denture wearers by oral rinse technique, with isolation on SDA; 2) to speciate and quantify Candida in non-denture wearers and denture wearers by using conventional methods (germ tube test, carbohydrate fermentation test, urease test) and the CHROMagar method; 3) to assess the influence of smoking and diabetes on candidal species among the denture wearers; and 4) to assess the sensitivity and specificity of SDA and CHRO Magar Materials and Methods: Salivary samples for Candida evaluation were collected from the subjects in sterile sample containers, using the oral rinse technique. Results: C glabrata was the most commonly found species among denture wearers and non-denture wearers both by conventional and CHROMagar methods. In males, C. albicans was the predominant species, whereas C. glabrata was the predominant species in females. Candidal colonization was higher in denture wearers compared to non-denture wearers, especially among females. The CHROMagar method was more rapid compared to conventional methods. In the present study, CHROMagar Candida showed 100% specificity and 100% sensitivity when compared to SDA and conventional methods.

CHROMagar KPC. Comparación con el método propuesto por los Centros para el Control y Prevención de Enfermedades (CDC, EE.UU.) para el estudio de portación rectal y evaluación de falsos positivos / CHROMagar KPC. Comparison with the method proposed by the Centers for Disease Control and Prevention (CDC, USA) for rectal screening and evaluation of false positive results

Se cultivaron 81 hisopados rectales en el medio CHROMagar KPC y por el método del CDC. Fueron positivos para Klebsiella pneumoniae KPC en CHROMagar KPC, 9/81 y 6/81 con el método del CDC. El medio CHROMagar KPC tuvo dos falsos positivos: 1 K. pneumoniae y 1 Acinetobacter sp. Los falsos positivos del método CDC fueron: 25 Acinetobacter spp., 2 Escherichia coli y4K. pneumoniae. El empleo del medio CHROMagar KPC resultó ser un método con mayor recuperación de aislamientos productores de KPC y menos falsos positivos que el método del CDC. Para evaluar los falsos positivos en el medio CHROMagar KPC se cultivaron 1247 hisopados rectales. Se obtuvieron 1021 negativos, 171 K. pneumoniae KPC y 55 (4,4 %) falsos positivos. Debido al desarrollo de falsos positivos en el medio CHROMagar KPC, se debe confirmar por caracterización fenotípica la presencia de KPC en las bacterias aisladas.

Eighty one rectal swabs (RS) were cultured on CHROMagar KPC and the CDC method. Of the 81 samples, 9 were positive for KPC-producing Klebsiella pneumoniae on CHROMagar KPC, and 6 for the CDC method. CHROMagar KPC had two false positive (FP) results: 1 K. pneumoniae and 1 Acinetobacter sp. FP results on the CDC method were: 25 Acinetobacter spp., 2 Escherichia coli and 4 K. pneumoniae. CHROMagar KPC yielded a better recovery of KPC-producing bacteria and less FP results than CDC method. In order to evaluate FP results on CHROMagar KPC, 1247 RS were cultured and yielded 1021 negatives, 171 KPC-producing K. pneumoniae and 55 FP (4.4 %). Because of the FP results growing on CHROMagar KPC, KPC must be phenotypically confirmed in the bacteria isolated.

Comparison of BBL chromagar MRSA to conventional media for the detection of methicillin resistant staphylococcus aureus in surveillance nasal swabs

Objectives This study aims to detect MRSA nasal carriers among medical staff and patients in Dermatology ward Hospital Kuala Lumpur by using two methods, the conventional blood sheep agar (BSA) and the novel BBL CHROMagar MRSA (C-MRSA). It also aims to compare the BSA medium with the C-MRSA medium in terms of specificity, sensitivity and time to detection to MRSA. Method A single centre, prospective study where 100 nasal swab samples were taken from medical staff and inpatients, then plated on to both BSA and C-MRSA. After 24 hours incubation, the plates were examined for presence of bacterial colonies, then incubated for another 24 hours if no colonies were present. All colonies on C-MRSA and BSA were subjected to coagulase and susceptibility testing for confirmation of MRSA. MRSA strains produce mauve colonies on CMRSA from hydrolysis of the chromogenic substance, thus C-MRSA uses colour as a diagnostic tool. Results Mauve colonies were present on nine C-MRSA plates in the first 24 hours which were all confirmed to be MRSA. Another nine CMRSA plates isolated bluish colonies which were not MRSA. There were colonies on 96 BSA plates, nine of which were MRSA. C-MRSA medium has 100% sensitivity and specificity in detecting MRSA. Both culture media had similar detection rates of MRSA from nasal swabs, however C-MRSA allows for earlier detection of MRSA within 24 hours compared to BSA which takes 48 hours. 2.2% of ward staff and 15.7% of inpatients were found to be MRSA carriers. Conclusion CHROMagar MRSA allows for more rapid identification of MRSA carriers within 24 hours compared to the conventional BSA which takes 48 hours. This allows earlier action to be taken to reduce the spread of MRSA infection.

Identification of Candida Species Using CHROMagar Candida in Superficial Cutaneous Candidiasis / 대한피부과학회지

BACKGOUND: CHROMagar Candida is a new differential culture medium that allows selective isolation and identification of clinically important Candida species. However, no study of CHROMagar Candida in superficial cutaneous candidiasis has been reported in Korea. OBJECTIVE: The purpose of this study was to evaluate the use of CHROMagar Candida to identify Candida species isolated from patients with cutaneous candidiasis. METHOD: A total of 95 strains isolated from 92 patients with candidiasis (70 Candida albicans, 9 Candida parapsilosis, 7 Candida guilliermondii, 1 Candida krusei, 1 Candida glabrata, 1 Candida tropicalis, 2 C. albicans plus C. parapsilosis, 1 C. albicans plus C. krusei) were subcultured to CHROMagar Candida (KOMED, Korea) and incubated for 48 hours. Colony appearance on CHROMagar Candida was assessed by two observers. RESULTS: Expected colony appearance on CHROMagar Candida was 100% for C. albicans, C. krusei, C. glabrata and C. tropicalis, respectively but 85.7% for C. guilliermondii and 77.8% for C. parapsilosis. Three mixed cultures of Candida species, not detected by conventional methods, were detected by CHROMagar Candida. CONCLUSION: CHROMagar Candida is a useful isolation medium capable of a rapid presumptive identification of Candida species and more reliable detection of mixed cultures in clinical specimens.

Evaluation of a New Chromogenic agar, CHROMagar Orientation, for Detection and Presumptive Identification of Urinary Tract Pathogens / 대한진단검사의학회지

BACKGROUND: Urine samples should be tested in a rapid and cost-effective way, as they represent the largest volume of specimens cultured in the microbiology laboratory. Some bacteria can be presumptively identified with CHROMagar Orientation (CO) according to the specific colors produced on the colonies. In this study, the usefulness of CO agar was evaluated for urine cultures. METHODS: The urine samples from 980 patients from March through April, 2004 were inoculated on blood agar (BAP), MacConkey agar, and CO agar plates, and we compared the detection rates of potential pathogens and the agreement between presumptive identification directly from the CO agar and the confirmative idntification, which was performed using Vitek systems (bioMerieux). RESULTS: The detection rates of urinary tract pathogens on all three media, conventional BAP, MacConkey agar and CO agar were identical (18.9%). All isolates of Escherichia coli (54) and ente-rococci (40) were correctly identified with CO agar. The overall agreement of presumptive identification was 87.4% (187/199). CONCLUSIONS: Use of the CO agar enabled a rapid presumptive identification of E. coli, and ente-rococci, the most common urinary tract pathogens. The CO agar is cost-effective by saving some of the bacterial identification kits that would be required for the conventional BAP and MacConkey agar method.

Utility of CHROMagar Orientation Medium for Urine Cultures / 임상검사와정도관리

BACKGROUND: Urine cultures are among the most numerous of culture types for microbiology studies. In this study, we evaluated the utility of CHROMagar Orientation (CO; Becton Dickinson, Cockeysville, MD, USA), a new chromogenic medium, for the detection, enumeration, and presumptive identification of urinary tract pathogens. METHODS: The 438 clinical urine samples sent for routine culture were plated onto CO and Bi-plate (blood/MacConkey agar). We compared the detection and enumeration of potential pathogens, and the agreement between presumptive identification directly from CO and the confirmative identification, which was performed using conventional biochemical tests and Vitek system. RESULTS: The detection rate of urinary tract pathogens on all two media, CO and Bi-plate were nearly identical. The enumeration of colony counts was consistent on the two media for 102 of the 108 (94%) microorganisms. Colony color and morphology on CO accurately differentiated Escherichia coli and Enterococcus spp. The overall agreement of presumptive identification on CO was 91 of the 108 (84%). CONCLUSION: The CO enabled accurate detection, count determination, and presumptive identification of common urinary pathogens, both in pure and mixed cultures.

Vulvovaginal candidosis caused by Candida Non-Albicans, proportion and clinical characteristics in the Dr. Cipto Mangunkusumo National General Hospital, Jakarta.

The prevalence of vulvovaginal candidosis (VVC) caused by C. non-albicans tends to increase, recently. The aim of this study was to obtain data about proportion and clinical characteristic of C. non-albicans VVC at dr. Cipto Mangunkusumo General Hospital, Jakarta. This is a cross-sectional study on all female patients with symptoms of VVC visiting Obstetri-gynaecology and Dermatovenereology outpatient clinics at dr. Cipto Mangunkusumo General Hospital, Jakarta. All subjects had positive Gram stain, showed Candida spp. on culture with CHROMagar Candida, and had no other specific genital infections. Sixty nine subjects aged 26–44 years old (averaged 29 years old) were included in this study. Candida non-albicans was found in 30.4% subject, and consisted of: C. glabrata (61.9%), C. tropicalis (28.6%) and C. parapsilosis (9.5%). We found that C. non-albicans VVC infections are more common in women above 45 years old, using non-hormonal contraceptives, whose sexual partner has erythema and pruritus in glands penis, and having the disease for more than 1 year. No differences in clinical symptoms were noted between C. albicans and C. non-albicans infection. We concluded from this study that the proportion of C. non-albicans infections at dr. Cipto Mangunkusumo General Hospital, Jakarta, with C. glabrata represents the most prevalent species. No characteristic clinical symptoms were found from the subjects with C. non-albicans VVC when compared with those infected by C. albicans.

Evaluation of CHROMagar Staph aureus, a New Chromogenic Medium, for the Detection of Nosocomial Methicillin-Resistant Staphylococcus aureus / 감염

BACKGROUND: Staphylococcus aureus remains one of the most frequently encountered bacterial pathogens and is responsible for a variety of mild to life- threatening infections. There is a substantial body of evidence that individuals who are asymptomatic nasal carriers of S. aureus are at increased risk of developing serious staphylococcal infections. Approximately 20% to 30% of health care workers at any given time are also nasal carriers of S. aureus. A subset of these may spread the organism to patients by direct contact transmission. CHROMagar Staph aureus (CSA) is a new chromogenic medium for identification of S. aureus on the basis of colony pigmentation. METHODS: The abilities of CSA, thermostable nuclease (DNase), and mannitol salt agar (MSA) to identify S. aureus isolates (n=70) and discriminate between S. aureus and coagluase-negative staphylococci (CoNS; n=8) were compared. RESULTS: CSA proved to be more sensitive and specific than DNase and MSA, allowing a reliable, simple, and rapid method for the identification of S. aureus isolates. All CoNS encountered in this study could be easily differentiated from S. aureus on the medium. The supplementation with 4 microgram/mL of oxacillin allowed simple identification of methicillin resistance in hospital acquired S. aureus strains which show multiple drug resistance profiles. CONCLUSION: CSA proved to be simple and reliable method for the identification of nasal carriers of S. aureus of health care workers.

CHROMagar Orientation Medium for Quick Detection of Urinary Tract Pathogens:A Clinical Evaluation / 中华医院感染学杂志

OBJECTIVE To investigate the function of CHROMagar orientation medium for quick detection of(urinary) tract pathogens.METHODS The comparative experiment was performed with CHROMagar orientation(medium) and 5% sheep blood agar for clinical urine specimens from the patient with suspective urinary tract(infections).RESULTS Among the total of 1369 clinical urine specimens,1023 specimens yielded no growth,344 specimens yielded growth on both media,and 2 other specimens yielded no growth on blood agar but yielded growth on CHROMagar orientation medium.CONCLUSIONS The growth of bacteria is not inhibited by the(orientation) medium and no significant differences were found in the results between the both media.The(orientation) medium can quickly confirm the genus of the pathogens,and it has significance for using antibiotics(reasonably).One of the greatest advantages of this medium is the easy recognition of mixed cultures.