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Species identification and biotyping of staphylococci by the API staph-ident system.

The API Staph-Ident system, a commercially available biochemical and chromogenic substrate micromethod, was evaluated as a means for identifying the species and determining the biotypes of human strains of staphylococci routinely encountered in a clinical microbiology laboratory. The species identity of 152 of 188 (80.9%) unique clinical isolates of staphylococci was correctly predicted by this method after 5 h of incubation according to the recommendations of the manufacturer. When results were determined after 24 h of incubation, the overall accuracy of this procedure was 90.4%. The API Staph-Ident system was not an adequate procedure for assessing strain biotypes since the patterns of biochemical reactivity observed with 53 of 54 (98.2%) unique isolates of Staphylococcus aureus were identical. Similarly, 58 of 62 (93.6%) different strains of S. epidermidis yielded the same biochemical profile.

Bacteriological Techniques

Rapid identification of group D streptococci with the API 20S system.

The API 20S system (Analytab Products) was evaluated as a means of identifying 209 isolates of Lancefield group D streptococci to the species level. Results were compared with those from a conventional tube biochemical identification system and from serological grouping. Use of the latest 20S computerized data base allowed species identification of 97% (203 of 209) of test isolates after a 4-h incubation period and 99% (208 of 209) of test isolates if supplemental overnight biochemical tests were used to clarify the identity of five Streptococcus bovis-variant isolates. The API 20S system appears to be a convenient and accurate method for rapid, same-day species identification of group D streptococci.

Enterococcus faecalis

Evaluation of the updated MS-2 Bacterial Identification system in comparison with the API 20E system.

The recently updated MS-2 Bacterial Identification system software (Abbott Laboratories, Diagnostic Division, Irving, Tex.) was compared with the original MS-2 Bacterial Identification software and the API 20E, using 968 strains of Enterobacteriaceae. The updated MS-2 software correctly identified 94.4% of the isolates tested. API 20E and the original MS-2 software correctly identified 91 and 85.3% of the strains, respectively. MS-2 responses were considered to be equivocal (needing additional tests for verification) if the percent likelihood values were less than 80%. The percentage of equivocal responses was reduced from 6.5% with the original software to 2.2% with the updated software, and the percentage of incorrect identifications was reduced from 8.2 to 3.4% with the original and updated software, respectively. Organisms belonging to 25 taxonomic groups were tested. Direct comparison of the two MS-2 programs showed that the updated MS-2 software increased the identification accuracy of Salmonella spp., Enterobacter cloacae, Providencia stuartii, Escherichia coli, Shigella spp., Klebsiella pneumoniae, Serratia marcescens, Proteus mirabilis, and Acinetobacter calcoaceticus. A decrease in accuracy was seen with Citrobacter freundii, Hafnia alvei, Enterobacter agglomerans, and Yersinia pseudotuberculosis when the updated software was used. The remaining 12 taxonomic groups were not affected by the software changes. The updated MS-2 software appears to significantly improve the identification accuracy of the MS-2 Bacterial Identification system.

Autoanalysis

Identification of Staphylococcus species of bovine origin with the API Staph-Ident system.

The API Staph-Ident system was evaluated as a means for identifying the species of bovine strains of staphylococci routinely isolated from quarter-milk samples. The species identity of 314 of 581 (54%) isolates of staphylococci was correctly determined by this method. The API Staph-Ident system was more accurate in correctly identifying Staphylococcus aureus (93.9%) than in correctly identifying non-S. aureus species (41.8%). False identifications of Staphylococcus epidermidis and Staphylococcus hominis were the main reasons for the incorrect identifications of the non-S. aureus species.

Animals

Comparison of the API Staph-Ident and DMS Staph-Trac systems with conventional methods used for the identification of coagulase-negative staphylococci.

Two commercial kit systems, the API Staph-Ident system (Analytab Products, Inc., Plainview, N.Y.) and the DMS Staph-Trac system (DMS Laboratories, Inc., Flemington, N.J.), were compared with conventional methods for the identification of nine species of coagulase-negative staphylococci. The API Staph-Ident system, a biochemical and chromogenic substrate micromethod, correctly identified 95 of 120 (79.2%) clinical isolates of coagulase-negative staphylococci after 5 h of incubation. The DMS Staph-Trac system, a miniaturized biochemical test system which requires a 24-h incubation period, correctly identified 106 (88.3%) of the same isolates. Both commercial systems were similar in cost and amount of technologist time required to inoculate and read each system. The clinical value of routine species identification of coagulase-negative staphylococci has not yet been established. The decision by clinical laboratories of whether to adopt this practice will be greatly facilitated by the availability of commercial kit systems which are both rapid and accurate.

Alkaline Phosphatase

Evaluation of the API 20 Strep system for species identification of streptococci isolated from bovine mastitis.

A new commercial system (API 20 Strep) for the species identification of streptococci associated with bovine mastitis was compared with the conventional biochemical methods. A total of 84 strains, including Streptococcus agalactiae (13), S. dysgalactiae (16), S. uberis (24), S. faecalis (12), S. faecium (5), and S. bovis (14) were tested. Using profile index and table data issued by the manufacturer, we identified 71.4% of strains by the API 20 Strep system. Our results indicate that improvement of the identification key is needed for accurate identification of streptococci isolated from bovine mastitis.

Animals

Identification of Gardnerella vaginalis with the API 20 Strep system.

A total of 137 strains of Gardnerella vaginalis were examined by the API 20 Strep system. The system was shown to be reliable when the tests were compared with standard identification methods, and very little confusion occurred with streptococcal profiles; consequently, G. vaginalis has been included in the API 20 Strep data base.

Female

Comparison of the MicroScan system with the API Staph-Ident system for species identification of coagulase-negative staphylococci.

To evaluate the accuracy of the MicroScan System (American Hospital Supply Corp., Sacramento, Calif.) for identification of coagulase-negative staphylococci, we tested 175 clinical isolates of coagulase-negative staphylococci. The results obtained by the MicroScan system were compared with those of the API Staph-Ident system (Analytab Products, Plainview, N.Y.). Forty-three discrepancies between the two systems were resolved by the conventional method of Kloos and Schleifer (W.E. Kloos and K.H. Schleifer, J. Clin. Microbiol. 1:82-88, 1975). The MicroScan and the Staph-Ident systems correctly identified 146 (86.4%) and 154 (88%) of 175 strains, respectively. The API system failed to identify phosphatase-negative Staphylococcus epidermidis. The MicroScan system demonstrated the greatest accuracy in the identification of S. epidermidis and S. saprophyticus, whereas lesser accuracy was achieved with S. hominis, S. warneri, and S. sciuri.

Bacteriological Techniques

Feasibility of same-day identification of members of the family Vibrionaceae by the API 20E system.

Sixty isolates, comprising nine species of the family Vibrionaceae, were tested with the API 20E 5-h same-day procedure (Analytab Products, Plainview, N.Y.). Included were 27 Aeromonas hydrophila isolates, 10 Aeromonas sobria isolates, 7 Aeromonas caviae isolates, 3 Plesiomonas shigelloides isolates, 3 Vibrio alginolyticus isolates, 3 Vibrio cholerae isolates, 1 Vibrio fluvialis isolate, 5 Vibrio parahaemolyticus isolates, and 1 Vibrio vulnificus isolate. The 5-h profile numbers were specific for the five Vibrio species and the Plesiomonas isolates. The three Aeromonas species shared seven 5-h profile numbers. Of the 63 5-h profile numbers generated by testing each isolate twice, 22 were identical to those found in the overnight analytical profile index. Of these, 20 were correct identifications, and two were incorrect. The remaining 41 5-h profile numbers were not found in the overnight analytical profile index. Because the 5-h analytical profile index does not contain any oxidase-positive organisms, the oxidase value was subtracted from the 63 5-h profile numbers to determine whether misidentifications could occur if the oxidase test was either not performed or not performed correctly. Only five of these factored profile numbers resulted in a possible misidentification. It is feasible, within limitations, to use the 5-h API 20E same-day procedure to identify the more commonly occurring members of the Vibrionaceae. The manufacturer should develop a data base for this purpose.

Aeromonas

Identification of Yersinia spp. with the API 20E system.

The ability of the API 20E system to identify 105 clinical isolates of Yersinia spp. was compared with those of conventional biochemical tests at 28 and 37 degrees C. Elimination of the Voges-Proskauer test (recorded as a negative result) increased the percentage of correct identifications for Yersinia spp. from 66 to 93% when the API 20E strips were incubated at 28 degrees C.

Bacteriological Techniques

Evaluation of the API 20C yeast identification system for the differentiation of some dematiaceous fungi.

Ninety-seven isolates of Cladosporium spp., Exophiala spp., Fonsecaea spp., Lecythophora hoffmannii, Phaeoannellomyces werneckii, Phialophora spp., Wangiella dermatitidis, and Xylohypha bantiana were used to evaluate the API 20C Yeast Identification System for the differentiation of dematiaceous fungi. Using the API 20C system, we were able to distinguish most species of Phialophora and Cladosporium and to separate L. hoffmannii from the species of Phialophora tested; X. bantiana from C. carrionii, C. resinae, and C. sphaerospermum; and W. dermatitidis from Exophiala jeanselmei and Exophiala spinifera. Ninety-two (60.1%) of 153 possible species-pair combinations were separated.

Cladosporium

Agreement between visual and automated UniScept API readings.

The UniScept API system was evaluated for agreement of visual versus automated readings of both its identification panels and its antimicrobial susceptibility panels. The biochemical responses of 340 oxidase-negative and oxidase-positive fermentative bacterial cultures were read both visually and automatically in the UniScept API 20E system. Automated and visual readings agreed with 99.3% of the biochemicals. Of the 45 tests that disagreed, the tests for indole and citrate were most often in disagreement. A total of 470 fermentative and nonfermentative cultures were used in the UniScept MIC system to compare visual and automated readings of susceptibility results with 17 antimicrobial agents. Agreement within +/- 1 dilution occurred with 94.1% of the enteric fermenters and with 91.7% of the other cultures. Comparison of visual and automated readings resulted in very major discrepancies in 0.95% of the readings, with the largest percentage of discrepancies associated with glucose nonfermenters (1.8%). It was felt that an automated reading is an acceptable alternative to a visual reading of the biochemicals but that 0.95% was just within the acceptable range of the 1% allowable very major discrepancies in the automated reading of susceptibilities.

Bacteria

Evaluation of the API 20 c microtube system for the identification of clinically important yeasts.

The API 20 C microtube system containing 20 biochemical tests for the identification of yeasts was compared with conventional tests used in the Mayo Clinic mycology laboratory. Three hundred isolates of clinically important yeasts were studied, and agreement of the carbohydrate fermentation and assimilation tests between the systems was good. The API 20 C represents a useful, commercially available screening method for the identification of yeasts; however, it is not a complete system and must be used in conjunction with microscopic morphological features and, when appropriate, with other biochemical tests.

Carbohydrate Metabolism

Evaluation of the modified API 20C system for identification of clinically important yeasts.

The modified API 20C system (Analytab Products, Inc.) containing 19 carbohydrate assimilation tests was used to identify stock cultures of clinical isolates and routine clinical isolates from the Mayo Clinic mycology laboratory. The system provided correct identifications for 96% of the 505 organisms tested. The API 20C represents a commercial system useful for the identification of yeasts from clinical specimens. Although reliable, it is not a complete system and must be used in conjunction with microscopic morphological features for definitive identification. Since the system requires 72 h for identification, it is not designed for the rapid presumptive identification of such organisms as Cryptococcus neoformans; other biochemical tests must be used for this purpose.

Diagnosis, Differential

The API ZYM system in the identification of Gram-negative anaerobes.

The API ZYM reactions of type species of Gram-negative anaerobes representative of those encountered in human infections and of 56 clinical isolates of such organisms, identified by conventional techniques, were investigated. The API ZYM test clearly distinguished between the different genera and species examined and appears to provide a simple, reliable method for the identification of this group of organisms.

Bacteriological Techniques

Four hour identification of Enterobacteriaceae with the API Rapid 20E and Micro-ID systems.

One hundred strains of Enterobacteriaceae were examined in parallel with the API Rapid 20E and Micro-ID commercial four hour identification systems. With the API Rapid 20E system 78% of the strains were correctly identified, 15% were not identified, and 7% were misidentified. The respective figures with the Micro-ID system were 74%, 11%, and 15%.

Bacteriological Techniques

Comparison of fluorescent antibody, bacitracin susceptibility, latex agglutination, coagglutination, and API 20S for identifying group A streptococci.

A total of 200 beta-hemolytic streptococci, isolated from clinical specimens submitted to our laboratory, were identified as group A versus non-A using the fluorescent antibody technique (FA), bacitracin susceptibility (BBL, Difco, and Raven disks), SeroSTAT, Streptex, Phadebact, and the API 20S system. Of the 122 group A isolates, all methods except SeroSTAT and Phadebact yielded 92-99% agreement when compared with the Lancefield precipitin test. Phadebact yielded an 84% agreement and SeroSTAT changed from 83 to 98% after trypsinization. Numerous false positives were obtained and only FA (91%) and API 20S (96%) yielded better than 90% agreement on non-A identification when compared with the Lancefield test. The most false positives were obtained (45%) using the SeroSTAT reagents. Considering accuracy, our data suggests the FA technique to be the method of choice for identifying group A streptococci.

Agglutination Tests

Identification of staphylococci from bovine udders: evaluation of the API 20GP system.

The API 20GP system (Analytab Products, Plainview, NY) correctly identified 56.1% of staphylococci isolated from the bovine mammary gland. The system identified 90.2% of Staphylococcus aureus strains, but failed to recognize strains of Staphylcoccus hyicus and others. Poor performance was attributed to the limited number of veterinary strains contained in the profile index data base. The API 20GP was determined to be an unacceptable method for identification of staphylococci isolated from the bovine mammary gland.

Animals