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Identification of Common Urinary Tract Pathogens

Identification of Common Urinary Tract Pathogens,J. Jang,W. Phillips,S. Strickler,A. Y. Hsiung

Identification of Common Urinary Tract Pathogens  
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Urine cultures are the most commonly performed tests in clinical laboratories, contributing significantly to laboratory expense and workload. Amongst positive urine cultures, E.coli is the most common causative agent and is associated with 90% of all urinary tract infections (UTI) in ambulatory patients, and 50% of nosocomial UTIs. In addition to E. coli, other common urine pathogens include Proteus, Enterococus, Pseudomonas, Enterobacter, Morganella, Klebsiella, Serratia, and Staphylococcus species. Many laboratories have attempted to decrease time and materials involved in UTI testing and diagnosis by using chromogenic media.(2) In this study, we evaluated the accuracy of HardyCHROM™ UTI in the detection and presumptive identification of the most common UTI pathogens. A total of 224 isolates previously identified to the species level were tested, including 100 clinical E. coli strains, 84 miscellaneous species of Enterobacteriaceae and P. aeruginosa, and 40 isolates of Gram positive organisms. In addition to the clinical strains, ATCC quality control organisms were evaluated as well to ensure accuracy. Performance was evaluated after twenty-four hours of incubation in an aerobic environment at 35°C. Of the 224 isolates tested, HardyCHROM™ UTI demonstrated 100% sensitivity and specificity with expected color reactions. A subset of the isolates (n=75) was also tested under Vitek™ I system to verify the identification accuracy of HardyCHROM™ UTI in comparison to the automated method, and also to rule out the possibility of the chromogens interfering with the identification reaction wells. All of the color reactions were found to be in accordance with the Vitek™ I results. The results of this study suggest that HardyCHROM™ UTI can be used as an accurate and reliable primary medium for the differentiation and identification of common UTI pathogens isolated in urine cultures. References Introduction (continued) Hardy Diagnostics' HardyCHROM™ UTI uses a combination of chromogens for the detection of the most common urinary tract pathogens. The chromogens in this media release chromophores when cleaved by enzymes unique to common UTI pathogens. This reaction results in the production of genera-specific colored colonies that allow for the presumptive identification of a large number of UTI genera. Clinical laboratories report E. coli as the most common pathogen responsible for the majority of urinary tract infections. With HardyCHROM™ UTI, E. coli colonies can be definitively identified as pink-rose colonies, with no further testing required. Enterococcus spp. can also be definitely identified as small teal colored colonies with no further testing on this media. Other common UTI pathogens that can be presumptively identified on HardyCHROM™ UTI include Klebsiella, Enterobacter, Serratia, Proteus, Morganella, Providencia, Pseudomonas, Staphylococcus aureus, Staphylococcus saprophyticus, and Candida spp. Materials and Methods
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