Ann Clin Microbiol.  2015 Mar;18(1):1-6. 10.5145/ACM.2015.18.1.1.

Evaluation of the Usefulness of MacConkey Agar and Colistin-Nalidixic Acid Blood Agar for Body Fluids, Peritoneal Fluid, and Wound/Abscess Specimens

Affiliations
  • 1Department of Laboratory Medicine, International St. Mary's Hospital, The Catholic Kwandong University of Korea, Incheon, Korea.
  • 2Department of Laboratory Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.
  • 3Samkwang Medical Laboratories, Seoul, Korea.
  • 4Department of Laboratory Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. yjpk@catholic.ac.kr

Abstract

BACKGROUND
Most clinical microbiology laboratories in Korea have difficulty in following the recommendations of the clinical procedure handbook for culture of body fluid and wound/abscess specimens. We evaluated the usefulness of MacConkey (MAC) and colistin-nalidixic acid blood agar (CNA) for the isolation of pathogens from these specimens.
METHODS
A total of 1,508 clinical specimens [144 peritoneal fluid, 241 body fluids (19 bile, 70 joint fluid, 6 pericardial fluid, 104 pleural fluid, and other fluids in 42 cases) and 1,123 wound/abscess] were inoculated onto basic media [Blood agar plate (BAP), chocolate agar or BAP with streaking of Staphylococcus aureus] and simultaneously inoculated onto MAC and CNA. The pathogens isolated by basic media and by additional use of MAC and/or CNA were compared.
RESULTS
With basic media, 885 isolates from 588 specimens were detected, and by additional use of MAC and CNA, an additional 27 isolates from 24 specimens and an additional 128 isolates from 112 specimens were isolated, respectively. Compared to the basic media, by adding MAC, an additional 233.3%, 38.5% and 4.5% of gram-negative bacteria were isolated from peritoneal fluids, body fluid and wound/abscess, respectively, and by adding CNA, an additional 106.7%, 45.0%, and 20.7% of gram-positive bacteria/ yeast were isolated, respectively. The isolates detected by additional use of MAC were mainly Enterobacteriaceae (77.0%), and those detected by CNA were S. aureus (21.1%), Coagulase-negative Staphylococcus spp. (20.3%), Enterococcus spp. (16.4%), Streptococcus spp. (10.2%) and yeasts (16.4%).
CONCLUSION
For peritoneal fluid and body fluid specimens, additional use of MAC plus CNA seems necessary for detection of pathogens. For wound/abscess, additional use of CNA will be cost effective.

Keyword

Body fluids; Colistin-nalidixic acid blood agar; McConkey agar; Peritoneal fluid; Wound/Abscess

MeSH Terms

Agar*
Ascitic Fluid*
Bile
Body Fluids*
Cacao
Enterobacteriaceae
Enterococcus
Gram-Negative Bacteria
Joints
Korea
Staphylococcus
Streptococcus
Yeasts
Agar

Reference

1.Bourbeau P., Riley J., Heiter BJ., Master R., Young C., Pierson C. Use of the BacT/Alert blood culture system for culture of sterile body fluids other than blood. J Clin Microbiol. 1998. 36:3273–7.
Article
2.Azap OK., Timurkaynak F., Sezer S., Cağ ir U., Yapar G., Arslan H, et al. Value of automatized blood culture systems in the diagnosis of continuous ambulatory peritoneal dialysis peritonitis. Transplant Proc. 2006. 38:411–2.
Article
3.Margaretten ME., Kohlwes J., Moore D., Bent S. Does this adult patient have septic arthritis? JAMA. 2007. 297:1478–88.
Article
4.Garcia LS., Isenberg HD. eds. Clinical Microbiology Pro-cedures Handbook. 3rd ed.American Society for Microbiology;2010.
5.Versalovic J., Carroll KC, et al. eds. Manual of Clinical Microbiology. 10th ed.American Society for Microbiology;2011. p. 281–91.
6.Bowler PG., Duerden BI., Armstrong DG. Wound microbiology and associated approaches to wound management. Clin Microbiol Rev. 2001. 14:244–69.
Article
7.Ellner PD., Stoessel CJ., Drakeford E., Vasi F. A new culture medium for medical bacteriology. Am J Clin Pathol. 1966. 45:502–4.
Article
8.Ninomiya K., Suzuki K., Koosaka S., Ueno K., Suzuki S. Phenylethyl alcohol agar medium for isolation of anaerobic bacteria. Jpn J Med Sci Biol. 1970. 23:403–11.
Article
9.Delost MD. Specimen Collection, Trasport, and Processing: Preli-minary Identification Methods. Delost MD, editor. Introduction to Diagnostic Microbiology for the Laboratory Sciences. 1st ed. Jones & Bartlett Learning;2015. p. 48–9.
10.Takahashi T., Sunaoshi K., Sunakawa K., Fujishima S., Watanabe H., Ubukata K. Invasive Streptococcal Disease Working Group. Clinical aspects of invasive infections with Streptococcus dysgalactiae ssp. Equisimilis in Japan: differences with respect to Streptococcus pyogenes and Streptococcus agalactiae infections. Clin Microbiol Infect. 2010. 16:1097–103.
11.Schrag SJ., Zywicki S., Farley MM., Reingold AL., Harrison LH., Lefkowitz LB, et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med. 2000. 342:15–20.
Article
12.Broyles LN., Van Beneden C., Beall B., Facklam R., Shewmaker PL., Malpiedi P, et al. Population-based study of invasive disease due to beta-hemolytic streptococci of groups other than A and B. Clin Infect Dis. 2009. 48:706–12.
13.Tazi A., Morand PC., Réglier-Poupet H., Dmytruk N., Billoët A., Antona D, et al. Invasive group B streptococcal infections in adults, France (2007-2010). Clin Microbiol Infect. 2011. 17:1587–9.
Article
14.Brandt CM., Spellerberg B. Human infections due to Streptococcus dysgalactiae subspecies equisimilis. Clin Infect Dis. 2009. 49:766–72.
15.Ortiz E., Sande MA. Routine use of anaerobic blood cultures: are they still indicated? Am J Med. 2000. 108:445–7.
Article
16.Fenner L., Widmer AF., Straub C., Frei R. Is the incidence of anaerobic bacteremia decreasing? Analysis of 114,000 blood cultures over a ten-year period. J Clin Microbiol. 2008. 46:2432–4.
Article
17.Park KH., Kim KH., Kang JH., Kim KN., Kim DS., Kim YK, et al. Current status and clinical presentations of invasive neonatal Group B streptococcal infections in Korea. Pediatr Int. 2011. 53:236–9.
Article
18.Choi TY., Kang JO., Pai HJ. Evaluation of automated blood culture system for body fluids culture other than blood. Korean J Clin Microbiol. 2011. 14:13–7.
Article
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