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The Journal of the Japanese Society for Clinical Microbiology |
Biblioraphy Information
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[Vol.25 No.4 contents] Japanese / English |
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| ArticleTitle | Accuracy and Cost-Effectiveness of the CHROMagar Orientation/ESBL medium for Identification and Detection of Extended-Spectrum β-Lactamase (ESBL)-Producing Gram-Negative Bacilli in Comparison to Conventional Methodology and Mass Spectrometry |
| Language | J |
| AuthorList | Asami Nakayama1), Hirofumi Ohtaki2), Kiyofumi Ohkusu3), Jun Yonetamari1), Natsuki Shirai1), Ayumi Niwa1), Hirotoshi Ohta1), Nobuyuki Furuta1), Tamayo Watanabe4), Hiroyasu Ito5), Nobuo Murakami4), Mitsuru Seishima5) |
| Affiliation |
1) Division of Clinical Laboratory, Gifu University Hospital 2) Department of Medical Technology, Kansai University of Health Sciences 3) Department of Microbiology, Tokyo Medical University 4) Center for Nutrition Support & Infection Control, Gifu University Hospital 5) Department of Informative Clinical Medicine, Gifu University Graduate School of Medicine |
| Publication | J.J.C.M.: 25 (4), 304-313, 2015 |
| Received | March 19, 2015 |
| Accepted | June 8, 2015 |
| Abstract | Automated microbiology systems for identification including mass spectrometry are already in widespread use in clinical microbiology. In recent years, advances in technology has allowed laboratorians to select from among the colonies isolated on various media and rapidly identify organisms; however, as clinical specimens often contain a mix of genera, species and clones often possessing resistance markers for antimicrobial agents, the selection of the appropriate colonies from mixed culture for identification and antimicrobial susceptibility testing remains a challenge in clinical microbiology. We evaluated the performance of CHROMagar Orientation (CHO)/ESBL medium which differentiates Gram-negative bacteria based on pigmentation and detection of extended spectrum β-lactamase (ESBL) producing organisms following overnight incubation. In the initial phase of the study, using ATCC isolates and previously identified clinical isolates, we showed 97.7% (85/87) agreement between CHO/ESBL and conventional methodology. In the prospective study, of the 264 isolates recovered from 207 clinical specimens there was 98.5% agreement (260/264) between CHO/ESBL and conventional methodology which was superior to selection of colonies for mass spectrometry which identified 93.1% (246/264) of the isolates. Of the 20 isolates confirmed to be ESBL-producers, all were detected by the CHO/ESBL differential medium. Operating cost using CHO/ESBL was shown to decrease 62% in comparison to conventional methodology. As CHO/ESBL allows the laboratorian to presumptively identify isolates as well as detect ESBL-producers simulataneously following overnight incubation, this significantly improves workflow thereby supporting earlier selection of the appropriate antimicrobial therapy and implementation of infection control measures. |
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| Copyright © 2002 The Japanese Society for Clinical Microbiology All rights reserved. |