A comparison of the performance of cystine lactose electrolyte deficient (CLED) agar with Oxiod chromogenic urinary tract infection (CUTI) medium for the isolation and presumptive identification of organisms from urine

Fallon, D.; Andrews, N.; Frodsham, D.; Gee, B.; Howe, S.; Iliffe, A.; Nye, K.J.; Warren, R.E.
July 2002
Journal of Clinical Pathology;Jul2002, Vol. 55 Issue 7, p524
Academic Journal
Aims: As part of the UK antimicrobial resistance strategy and action plan, the Public Health Laboratory Service (PHLS) is required to collect antibiotic susceptibility data so that resistance trends and patterns can be monitored. Most laboratories report urine Gram negative isolates, as 'coliforms' according to morphological appearance, but without an acceptable identification system the antimicrobial surveillance data will be meaningless. Commercially available identification systems tend to be expensive and time consuming. Chromogenic agars, which claim to improve the detection of mixed cultures and identification of organisms from urine, have now become available and may provide a cost effective alternative. The primary aim of this study was to compare the performance of cystine lactose electrolyte deficient (CLED) agar with a chromogenic agar (Oxoid urinary tract infection medium; CUTI) in terms of isolation rates and ability to detect mixed cultures. Secondary aims were to evaluate the correlation of "presumptive" identification of isolates from chromogenic media with that of two commercial identification systems and to appraise the sensitivity of the semiquantitative loop and filter paper strip culture techniques. Method: One thousand, four hundred and sixty six urine samples were examined in four laboratories using the semiquantitative culture methods of 1 μl loop and filter paper strip. The degree of accuracy of organism identification was measured by comparing the presumptive identification using colony colour supplemented with simple bench tests, with identification obtained from two more complex commercial systems. Results: There was no significant difference between the performance of the loop and filter paper strip methods on the CLED agar, but the CUTI agar performed significantly better than the CLED agar for the detection of significant isolates and mixed cultures. This difference was greater using the loop method. Identification of the...


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