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Identification of Enterobacteriaceae by the API 20E system.

Since the introduction of the API 20E kit a number of identification schemes have been developed by the manufacturer for use with the kit. We evaluated the success of these various schemes in identifying 206 strains belonging to 34 taxa of the family Enterobacteriaceae. Many of the strains were atypical and only 94% could be identified by our own system of 50 conventional tests and a computer program. The most advanced identification scheme so far developed for the API 20E kit (the Analytical Profile Index and complementary Computer Service) allowed 88% of the 206 strains to be correctly identified, although 2% were incorrectly identified. The tests in the API 20E kit and 52 conventional tests were separately evaluated for their ability to discriminate between the 34 taxa considered in this study. Our results suggest that replacing some of the tests in the present API 20E kit might further improve its diagnostic performance.

Bacteriological Techniques

[Experiences with the API 20A system in routine species identification of anaerobes (author's transl)].

The API 20A System was tested in three modifications: a) The microtubes were inoculated with the API anaerobe basal medium, filled up completely with sterile mineral oil and incubated aerobically. b) The test strips were inoculated with the basal medium and incubated in an anaerobic chamber. c) The strips were inoculated with a modified Viande-Levure medium containing Tween 80, vitamin K3 and hemin. The microtubes were covered with sterile mineral oil and incubated in an anaerobic chamber. Each procedure was compared with the conventional method (PRAS) of the Virginia Polytechnic Institute. The overall agreement between the three modifications of the API System and the conventional method was 83.2, 91.7, and 98.5% related to the number of tests performed. The advantage of the modified medium was also demonstrated by measuring the growth rate of some anaerobes in thioglycolate broth, API basal medium and VL-medium, modified as mentioned above, nephelometrically. So the micromethod is more accurate and reliable when inoculated with an improved medium.

Anaerobiosis

An evaluation of the API ZYM system as a means of identifying Haemophilus somnus and related taxa.

The commercially available API ZYM microbiological identification system was evaluated for the rapid identification of Haemophilus somnus. Eighty-seven isolates of the organism had API ZYM profiles which were characteristic. The API ZYM profiles demonstrate clear differences between H. somnus and other genera but suggest a close association to three related organisms. Enzyme activity of H. somnus isolates were similar to organisms identified as Histophilus ovis, Haemophilus agni and strains UQV of Actinobacillus actinoides and Actinobacillus seminis but was clearly different from isolates of Pasteurella haemolytica, Pasteurella multocida, Bordetella bronchiseptica and group EF4. The API ZYM system allowed more rapid identification of H. somnus than conventional biochemical tests and may be a useful adjunct to conventional methods used for identification of H. somnus isolates. The test did not reveal obvious differences between isolates from various anatomic locations.

Bacteriological Techniques

Evaluation of the API 20 STREP system for species identification of "viridans" streptococci isolated from bacteremia.

Species identifications of 71 strains of viridans streptococci isolated from blood and 4 reference strains were made by the API 20 STREP system (API system S. A., Montalieu-Vercien, France) and the conventional method. There are high levels of agreement between results obtained with the both methods for determining acidification from carbohydrate except inulin. The API 20 STREP system correctly identified 74.7% of the viridans streptococci with 9.3% low descrimination, 12% incorrect and 4% unidentified. All strains of S. mitis, S. mutans, S. salivarius and S. anginosus-constellatus were correctly identified. The correct identification rates for S. sanguis I, S. sanguis II and S. MG-intermedius were 88.9%, 68% and 61% respectively. The difference of inulin reaction and the taxonomy discrepancy may be the cause of different identification. The study indicates that the API 20 STREP system has a good potentiality for species identification of viridans streptococci at present time, however, further refinement in needed.

Bacteriological Techniques

Kloeckera apis st. nov.; the imperfect state of Hanseniaspora guilliermondii Pijper.

K. apiculata var. apis (nom. nud.) was found to be the imperfect state of H. guilliermondii Pijper by a high degree of DNA reassociation. The name is validated and raised to species rank, K. apis Lavie ex Smith, Simione and Meyer. K. apis and H. guilliermondii could be distinguished from H. uvarum and H. valbyensis by a low DNA reassociation and by growth at 37 C.

DNA

Alcohol dehydrogenase polymorphism in Apis mellifera.

A polymorphic system of ADH isozymes is described in the honeybee Apis mellifera. Three and six different electrophoretic patterns were found, respectively, in drone and worker pupae analysis. The data indicate that the ADH isozymes are controlled by three alleles, Adh-1(1), Adh-1(2), and Adh-1(3). The frequency of the Adh-1 alleles is different in two analyzed subspecies, Apis mellifera adansonii (African bees) and Apis mellifera ligustica (Italian bees). In the African bees, the frequencies are 0.256 and 0.697 for Adh-1(1) and Adh-1(2), respectively. In the Italian bees, these values are shown to be 0.902 and 0.098, respectively. The allele Adh-1(3) was not detected in the Italian bee population. The effect of NAD on the resolution of this system was investigated, and only one region of ADH activity was obtained in drone pupae analysis when NAD was used in the gels. However, two different regions of activity were observed in the same samples, in the absence of the coenzyme. ADH activity was not detected in young larvae, but it increased to a maximum in prepupal and white-eyed pupal phases. It then declined progressively to total absence in the emerging bees.

Alcohol Oxidoreductases

Comparative evaluation of RapID ANA and API 20 A for identification of anaerobic bacteria.

This study evaluated RapID ANA and API 20 A systems for identification of anaerobic gram-positive and gram-negative bacteria isolated from oral and non-oral infections using standard reference methods. A total of 480 isolates were tested in both systems. The RapID ANA system correctly identified 74% of the strains to species level and 17.5% to genus level; 5% were misidentified. The API 20 A system correctly identified 50% of the strains to species level and 24.5% to genus level; 8% were misidentified and 17.5% could not be identified by the API 20 A system.

Bacteria, Anaerobic

APIS: a software for model identification, simulation and dosage regimen calculations in clinical and experimental pharmacokinetics.

APIS is a software package based on mathematical modelling which provides a reliable approach in optimizing drug therapy. It was designed to assist clinicians in interpreting blood drug levels so that drug therapy may be better and more cost-effective. It is a methodological approach to describe, predict and control the kinetic behaviour of a drug. This software incorporates the principle of Bayesian procedures, i.e. one can use all available patient information (population) to determine patient-specific parameter estimates. These estimates can then be used to design an optimal and individualized drug regimen. APIS is an attractive and useful tool for clinical and experimental pharmacokinetics. APIS may be used on any IBM compatible computer using the Microsoft-Windows environment. The software is menu driven to provide a very user-friendly tool for analysing pharmacokinetic data and for designing dosage regimens.

Amikacin

Rapid identification of Haemophilus somnus, Histophilus ovis and Actinobacillus seminis using the API ZYM system.

The API ZYM system, a commercially-available technique that measures bacterial enzyme activity was used to test 43 isolates identified as H. somnus, H. ovis or A. seminis and 19 from related genera. The enzyme patterns resulting from the API ZYM differentiated H. somnus and H. ovis from A. seminis and related genera but not from each other. An identification scheme based on 9 of the enzymes in the API ZYM and a few simple biochemical tests is proposed for the rapid and reliable identification of these bacteria in a diagnostic bacteriology laboratory.

Actinobacillus

Evaluation of API 20 NE in routine diagnostics of nonfermenting gram-negative rod-shaped bacteria.

292 strains of non-fermenting Gram-negative rod-shaped bacteria were determined by standard methods and tested in a new commercial microidentification-system, the API 20 NE (api Biomérieux). A total of 282 (= 96,6%) strains were identified conformably; 130 (= 46,1%) after 24 h and 77 (= 27,3%) within 48 h. In 75 (= 26,6%) cases different conventional additional tests for determination to species level were necessary. The reasons for divergent results of 10 strains are discussed. The new microidentification system API 20 NE might be a simple and reliable tool in hand of the skilled medical microbiologist.

Alcaligenes

Comparison of Minitek Anaerobe II, API An-Ident, and RapID ANA systems for identification of Clostridium difficile.

Three commercial anaerobic systems, Minitek (BBL Microbiology Systems, Cockeysville, MD), API An-Ident (Analytab Products, Plainview, NY), and RapID ANA (Innovative Diagnostic Systems, Decatur, GA) were evaluated for ability to identify 45 Clostridium difficile isolates accurately. Minitek correctly identified 66% of C. difficile isolates to species, 27% were incompletely identified, and 7% were misidentified. Most of the discrepancies with Minitek were due to false negative biochemical results. API An-Ident correctly identified 9% C. difficile isolates to species, 89% were incompletely identified, and 2% were misidentified. Most of the API An-Ident discrepancies were due to the data base, which distinguished poorly between C. difficile, Clostridium hastiforme, and Clostridium sporogenes. RapID ANA correctly identified 100% of C. difficile isolates.

Adult

Comparison of API Rapid Strep, Baxter MicroScan Rapid Pos ID Panel, BBL Minitek Differential Identification System, IDS RapID STR System, and Vitek GPI to conventional biochemical tests for identification of viridans streptococci.

Viridans group streptococci (36 stock strains and 167 single patient blood culture isolates) were assessed using API Rapid Strep, Baxter MicroScan Rapid Pos ID Panel, BBL Minitek Differential Identification System, IDS RapID STR System, and Vitek GPI methods. Identification data obtained with these systems were compared with those indicated by conventional biochemical procedures. API, Baxter MicroScan, BBL, IDS, and Vitek corresponded with conventional biochemical identification in 74%, 66%, 65%, 50%, and 61% of the isolates, respectively; using recommended supplemental tests, agreement was augmented in 9%, 11%, 20%, 11%, and 21% of the isolates, respectively. Disagreement with conventional biochemical methods occurred in 14%, 17%, 14%, 32%, and 10% of the commercial techniques, respectively; no identification was possible in 2%, 5%, fewer than 1%, 6%, and 8% of specimens, respectively. BBL, API, and Baxter MicroScan systems provided the most reliable rapid identification, although supplemental testing often was required. Until a higher percentage of correct identification data can be obtained without supplemental procedures, conventional biochemical techniques will remain the methods of choice for identification of viridans streptococci.

Bacteriological Techniques

A physiological classification of viridans streptococci by use of the API-20STREP system.

Physiological reactions of viridans streptococci were examined by the API-20STREP system and a selection of conventional tests. Cluster analysis of these results produced a classification similar to a taxonomic scheme based on that of Colman and Williams. The organisms could be divided into the six recognised species--Streptococcus mutans, S. bovis, S. mitior, S. sanguis, S. salivarius and S. milleri. Analysis confirmed that S. mitior and S. sanguis can be distinguished in the API-20STREP test by hydrolysis of arginine but not by dextran production. Although S. mutans, S. mitior and S. sanguis can be divided into two further subgroups, the taxonomic significance of this is unclear. With this means of classification, most organisms could be identified easily by a small number of tests. API-20STREP is convenient for performing physiological tests on viridans streptococci, but the information provided by the manufacturers in regard to identification and nomenclature is in need of revision.

Bacteriological Techniques

Construction of an interpretive pattern directory for the API 10 S kit and analysis of its diagnostic accuracy.

A directory of test patterns and their interpretations has been prepared for identification of Enterobacteriaceae by using the 11-test API 10 S kit. The diagnostic accuracy of the directory and kit were evaluated by using records of test results for 37,476 isolates studied with the 21-test API 20 Enteric kit. Analysis indicates that 96.9% of the isolates would have been correctly identified at the genus level and 95.9% at the species level by using only the subset of tests included in the API 10 S.

Bacteriological Techniques

Clinical evaluation of the MICRO-ID, API 20E, and conventional media systems for identification of Enterobacteriacea.

MICRO-ID (General Diagnostics, Morris Plains, N.J.) is a new kit system designed for the identification of Enterobacteriaceae in 4 h. It consists of 15 biochemical tests of paper disks. Each test is in its own compartment in a molded plastic tray. Only one reagent need be added to the system (2 drops of 20% KOH, which is added to the Voges-Proskauer test). Based on the pattern of positive and negative biochemical test results, a five-digit octal code number is calculated. An identification is derived from a computer-generated identification manual. A study was conducted to compare three systems-the MICRO-ID 4-h and the API 20E (Analytab Products Inc., Plainview, N.Y.) 18- to 24-h systems and a conventional media system-to measure the ability of each to identify members of the family Enterobacteriaceae. Comparison tables, rather than simple percentage agreement tables, were generated to define the particular strengths and weaknesses of each system and allow the laboratory to best use the data. The MICRO-ID compared quite favorably with conventional media. MICRO-ID yielded incorrect identifications with 1.5% of the isolates tested (API 20E, 4.7% misidentification rate). Half the MICRO-ID misidentifications occurred when the system identified a Citrobacter diversus as a lysine-negative Escherichia coli; all gave one octal number. A direct comparison of the MICRO-ID and API 20E was of limited value because percentage agreements were merely the sums of the errors of each. The ease of inoculation, the requirement for the addition of only one reagent, and the 4-h capability make the MICRO-ID system an extremely attractive development in the field of bacterial identification.

Bacteriological Techniques

Evaluation of the new API 20C strip for yeast identification against a conventional method.

The new API 20C yeast identification system together with appropriate microscopic morphology determinations achieved a 97% correlation with a rapid conventional method. Whereas a group composed of Candida, Torulopsis, Saccharomyces, and Rhodotorula was identified with ease (98% overall correlation), a second group, containing Cryptococcus, Trichosporon, and Geotrichum species, appeared to give the system the most difficulty (90% correlation). Within this group particular difficulty was encountered in identifying varieties of Cryptococcus albidus, C. terreus, C. laurentii, Trichosporon beigelli, and Geotrichum spp. as to species. The API 20C system should be incubated the full 72 h prescribed by the manufacturer. However, when used in conjunction with appropriate morphological tests, presumptive identifications of some Candida and Torulopsis species may be made at 24 to 48 h. To facilitate identifications of the more difficult group of yeasts, ancillary tests for determining nitrate reductase, urease, and phenol oxidase activities should be considered as additions to the strip. Incorporating the phenol oxidase test would be especially important for identification of Cryptococcus neoformans, a yeast which should be identified as quickly and as accurately as possible. The API 20C system with computer assistance has proved to be an easy-to-inoculate, versatile, and fairly rapid method of yeast identification, giving results comparable to those obtained by conventional methodologies.

Candida

Comparison of the Quantum II, API Yeast Ident, and AutoMicrobic systems for identification of clinical yeast isolates.

The Quantum II Yeast Identification System (Abbott Laboratories) is a microprocessor-based spectrophotometric system for identification of clinical yeast isolates within 24 h. We compared the Quantum II system with the API Yeast Ident (Analytab Products) and the AutoMicrobic System Yeast Biochemical Card (AMS-YBC; Vitek Systems, Inc.) for the identification of 221 clinical yeast isolates, including 120 common clinical isolates (Candida albicans, C. tropicalis, C. parapsilosis, Torulopsis glabrata, and Cryptococcus neoformans) and 101 relatively uncommon clinical isolates. The API 20C (Analytab) was used as the reference system. The Quantum II and AMS-YBC systems correctly identified 181 (82%) and 184 (83%) isolates, respectively, whereas the Yeast Ident system correctly identified 132 (60%) isolates. Of the 120 common clinical isolates, 113 (94%) were correctly identified by Quantum II, 103 (86%) were correctly identified by AMS-YBC, and 83 (69%) were correctly identified by Yeast Ident. Of the 101 uncommon clinical isolates tested, 68 (67%) were correctly identified by Quantum II, 81 (80%) were correctly identified by AMS-YBC, and 49 (49%) were correctly identified by Yeast Ident. The overall accuracy of the Quantum II, AMS-YBC, and API Yeast Ident was not sufficient to recommend any of these systems for routine use in the clinical microbiology laboratory without substantial expansion of the respective data bases.

Diagnostic Errors

Identification of Actinomyces (Corynebacterium) pyogenes with the API 20 Strep system.

A total of 62 strains of Actinomyces pyogenes (previously Corynebacterium pyogenes) were examined by the API 20 Strep system (API System, La Balme Les Grottes, Montalieu-Vercieu, France). The system was shown to be reliable and rapid when the tests were compared with standard identification methods. No confusion occurred with streptococcal profiles in the current API 20 Strep data base.

Actinomyces