Evaluation of chromogenic agar medium, can it be a suitable alternative to conventional culture system for identification of uropathogens?
,
Abstract
Background and Objectives: Urinary tract infections (UTI) account for major proportion of outpatient load and hospital admission globally. In most of the clinical microbiology laboratories MacConkey agar (MAC) and Cystine lactose electrolyte-deficient (CLED) agar are being used for identification of uropathogens. The main objective of the present study was to evaluate the usefulness of HiCromeTM UTI by comparing isolation rate and presumptive identification of uropathogens against CLED and MAC agar.
Materials and Methods: This study was conducted over a period of three months on 672 non-duplicate midstream and/or catheter-catch urine samples. All samples were inoculated on to HiCromeTM UTI, CLED agar and MacConkey agar.
Results: Among the 672 samples received for culture, 113 (16.8%) showed significant growth. Among the 672 samples, 95 (14.1%) showed growth of a single organism while 18 (2.7%) showed polymicrobial growth. The rate of isolation and presumptive identification of the isolates and polymicrobial growth was found significantly higher on HiCromeTM UTI Agar.
Conclusion: HiCromeTM UTI Agar has the potential to streamline processing of samples for urine culture in a way that will reduce the workload for technicians, reduce turnaround time which in turn will benefit the laboratory ultimately leading to better patient care.
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2. Behzadi P, Behzadi E, Pawlak‑Adamska EA. Urinary tract Infections (UTIs) or genital tract infections (GTIs)? It’s the diagnostics that count. GMS Hyg Infect Control 2019;14:Doc14.
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8. Anjum M, Moorani KN, Sameen I, Mustufa MA, Kulsoom S. Functional and structural abnormalities of the kidney and urinary tract in severely malnourished children ‑ A hospital based study. Pak J Med Sci 2016;32:1135‑1140.
9. Chu CM, Lowder JL. Diagnosis and treatment of urinary tract infections across age groups. Am J Obstet Gynecol 2018; 219: 40-51.
10. Salvatore S, Salvatore S, Cattoni E, Siesto G, Serati M, SoriceP, et al. Urinary tract infections in women. Eur J Obstet Gynecol Reprod Biol 2011;156:131-136.
11. Dasgupta C, Rafi MA, Salam MA. High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh. Pak J Med Sci 2020;36:1297-1302.
12. Price TK, Dune T, Hilt EE, Thomas-White KJ, Kliethermes S, Brincat C, et al. The clinical urine culture: enhanced techniques improve detection of clinically relevant microorganisms. J Clin Microbiol 2016;54:1216-1222.
13. Chang JC, Chien ML, Chen HM, Yan JJ Wu JJ. Comparison of CPS ID 3 and CHROMagar Orientation chromogenic agars with standard biplate technique for culture of clinical urine samples. J Microbiol Immunol Infect 2008; 41: 422-427.
14. Rigaill J., Verhoeven P.O., Mahinc C., Jeraiby M., Grattard F., Fonsale N., Pozzetto B. and Carricajo A.. 2015. Evaluation of new bioMérieux chromogenic CPS media for detection of urinary tract pathogens. J Clin Microbiol 53: 2701-2702.
15. Stefaniuk E, Baraniak A, Fortuna M, Hryniewicz W. Usefulness of CHROMagar Candida medium, biochemical methods – API ID32C and VITEK 2 Compact and two MALDI-TOF MS Systems for Candida spp. identification. Polish J Microbiol 2016;65: 111-114.
16. Bouslah Z, Mahjoub R, Allagui Z, Dabboussi M, Zouaoui M, Bibi A. Contribution of the Uriselect4® and the CPS ID3® chromogenic media to the isolation and identification of urinary tract infections bacteria. Ann Biol Clin (Paris) 2020;78:47-53.
17. Payne M, Roscoe D. Evaluation of two chromogenic media for the isolation and identification of urinary tract pathogens. Eur J Clin Microbiol Infect Dis 2015;34:303-308.
18. Meddeb M, Maurer M, Grillon A, Scheftel JM, Jaulhac B. Comparison of routine use of two chromogenic media ChromID CPS (bioMérieux) and UriSelect4 (Bio-Rad) for the detection of Escherichia coli and major uropathogenics in urine. Ann Biol Clin (Paris) 2014;72:224-230.
19. Manickam K, Karlowsky JA, Adam H, Lagacé-Wiens PR, Rendina A, Pang P, Murray BL, Alfa MJ. CHROMagar Orientation medium reduces urine culture workload. J Clin Microbiol 2013;51:1179-1183.
20. Piñeiro Pérez R, Cilleruelo Ortega MJ, Ares Álvarez J, Baquero-Artigao F, Silva Rico JC, Velasco Zúñiga R, et al. Recommendations on the diagnosis and treatment of urinary tract infection. An Pediatr (Engl Ed) 2019;90(6):400.e1-400.e9.
21. Campbell I. Chi-squared and Fisher-Irwin tests of two-by-two tables with small sample recommendations. Stat Med 2007;26:3661-3675.
22. Kuch A, Stefaniuk E, Ozorowski T, Hryniewicz W. New selective and differential chromogenic agar medium, chromID VRE, for screening vancomycin-resistant Enterococcus species. J Microbiol Methods 2009; 77: 124-126.
23. Ciragil P, Gul M, Aral M, Ekerbicer H. Evaluation of a new chromogenic medium for isolation and identification of common urinary tract pathogens. Eur J Clin Microbiol Infect Dis 2006;25:108-111.
24. Stefaniuk EM. The usefulness of chromogenic media for qualitative and semi-quantitative diagnostic of urinary tract infections. Pol J Microbiol 2018;67:213-218.
25. Perry JD. A Decade of development of chromogenic culture media for clinical microbiology in an era of molecular diagnostics. Clin Microbiol Rev 2017;30:449-479.
26. Akter ML, Haque R, Salam MA. Comparative evaluation of chromogenic agar medium and conventional culture system for isolation and presumptive identification of uropathogens. Pak J Med Sci 2014;30:1033-1038.
27. Khalid M. Comparison of chromogenic (HiCrome urinary tract infection agar) medium with cysteine lactose electrolyte deficient agar in a resource-limited setting. Int J Appl Basic Med Res 2021;11(1):9-13.
28. Rajaratnam A, Baby NM, Kuruvilla TS, Machado S. Diagnosis of asymptomatic bacteriuria and associated risk factors among pregnant women in Mangalore, Karnataka. J Clin Diagn Res 2014;8:OC23‑25.
29. Mohan B, Gupta P, Appannanavar SB, Singh G, Taneja N. Evaluation of new chromogenic media for identification of uropathogens from complicated urinary tract infections in a tertiary healthcare setting. Indian J Med Microbiol 2015;33:183‑184.
30. Perry JD, Freydiere AM. The application of chromogenic media in clinical microbiology. J Appl Microbiol 2007;103:2046-2055.
31. Yarbrough M.L., Wallace M.A., Marshall C., Mathias E. and Burnham A.-A.D.. 2016. Culture of urine specimens by use of chromID CPS Elite medium canexpedite Escherichia coli identification and reduce hands-on time in the clinical laboratory. J Clin Microbiol 54: 2767-2773.
2. Behzadi P, Behzadi E, Pawlak‑Adamska EA. Urinary tract Infections (UTIs) or genital tract infections (GTIs)? It’s the diagnostics that count. GMS Hyg Infect Control 2019;14:Doc14.
3. Worku S, Derbie A, Sinishaw MA, Adem Y, Biadglegne F. Prevalence of bacteriuria and antimicrobial susceptibility patterns among diabetic and nondiabetic patients attending at Debre Tabor Hospital, Northwest Ethiopia. Int J Microbiol 2017;2017:5809494.
4. Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol 2019;11:1756287219832172.
5. Qaiser S, Zeeshan M, Jabeen K, Ahsan T, Zafar A. Comparison of chromogenic urinary tract infection medium with cysteine lactose electrolyte deficient media in aresource limited setting. J Pak Med Assoc 2011;61(7):632-635.
6. Kranz J, Schmidt S, Lebert C, et al. The 2017 update of the German clinical guideline on epidemiology, diagnostics, therapy, prevention, and management of uncomplicated urinary tract infections in adult patients: part 1. Urol Int 2018; 100: 263-270.
7. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol 2015;13:269-284.
8. Anjum M, Moorani KN, Sameen I, Mustufa MA, Kulsoom S. Functional and structural abnormalities of the kidney and urinary tract in severely malnourished children ‑ A hospital based study. Pak J Med Sci 2016;32:1135‑1140.
9. Chu CM, Lowder JL. Diagnosis and treatment of urinary tract infections across age groups. Am J Obstet Gynecol 2018; 219: 40-51.
10. Salvatore S, Salvatore S, Cattoni E, Siesto G, Serati M, SoriceP, et al. Urinary tract infections in women. Eur J Obstet Gynecol Reprod Biol 2011;156:131-136.
11. Dasgupta C, Rafi MA, Salam MA. High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh. Pak J Med Sci 2020;36:1297-1302.
12. Price TK, Dune T, Hilt EE, Thomas-White KJ, Kliethermes S, Brincat C, et al. The clinical urine culture: enhanced techniques improve detection of clinically relevant microorganisms. J Clin Microbiol 2016;54:1216-1222.
13. Chang JC, Chien ML, Chen HM, Yan JJ Wu JJ. Comparison of CPS ID 3 and CHROMagar Orientation chromogenic agars with standard biplate technique for culture of clinical urine samples. J Microbiol Immunol Infect 2008; 41: 422-427.
14. Rigaill J., Verhoeven P.O., Mahinc C., Jeraiby M., Grattard F., Fonsale N., Pozzetto B. and Carricajo A.. 2015. Evaluation of new bioMérieux chromogenic CPS media for detection of urinary tract pathogens. J Clin Microbiol 53: 2701-2702.
15. Stefaniuk E, Baraniak A, Fortuna M, Hryniewicz W. Usefulness of CHROMagar Candida medium, biochemical methods – API ID32C and VITEK 2 Compact and two MALDI-TOF MS Systems for Candida spp. identification. Polish J Microbiol 2016;65: 111-114.
16. Bouslah Z, Mahjoub R, Allagui Z, Dabboussi M, Zouaoui M, Bibi A. Contribution of the Uriselect4® and the CPS ID3® chromogenic media to the isolation and identification of urinary tract infections bacteria. Ann Biol Clin (Paris) 2020;78:47-53.
17. Payne M, Roscoe D. Evaluation of two chromogenic media for the isolation and identification of urinary tract pathogens. Eur J Clin Microbiol Infect Dis 2015;34:303-308.
18. Meddeb M, Maurer M, Grillon A, Scheftel JM, Jaulhac B. Comparison of routine use of two chromogenic media ChromID CPS (bioMérieux) and UriSelect4 (Bio-Rad) for the detection of Escherichia coli and major uropathogenics in urine. Ann Biol Clin (Paris) 2014;72:224-230.
19. Manickam K, Karlowsky JA, Adam H, Lagacé-Wiens PR, Rendina A, Pang P, Murray BL, Alfa MJ. CHROMagar Orientation medium reduces urine culture workload. J Clin Microbiol 2013;51:1179-1183.
20. Piñeiro Pérez R, Cilleruelo Ortega MJ, Ares Álvarez J, Baquero-Artigao F, Silva Rico JC, Velasco Zúñiga R, et al. Recommendations on the diagnosis and treatment of urinary tract infection. An Pediatr (Engl Ed) 2019;90(6):400.e1-400.e9.
21. Campbell I. Chi-squared and Fisher-Irwin tests of two-by-two tables with small sample recommendations. Stat Med 2007;26:3661-3675.
22. Kuch A, Stefaniuk E, Ozorowski T, Hryniewicz W. New selective and differential chromogenic agar medium, chromID VRE, for screening vancomycin-resistant Enterococcus species. J Microbiol Methods 2009; 77: 124-126.
23. Ciragil P, Gul M, Aral M, Ekerbicer H. Evaluation of a new chromogenic medium for isolation and identification of common urinary tract pathogens. Eur J Clin Microbiol Infect Dis 2006;25:108-111.
24. Stefaniuk EM. The usefulness of chromogenic media for qualitative and semi-quantitative diagnostic of urinary tract infections. Pol J Microbiol 2018;67:213-218.
25. Perry JD. A Decade of development of chromogenic culture media for clinical microbiology in an era of molecular diagnostics. Clin Microbiol Rev 2017;30:449-479.
26. Akter ML, Haque R, Salam MA. Comparative evaluation of chromogenic agar medium and conventional culture system for isolation and presumptive identification of uropathogens. Pak J Med Sci 2014;30:1033-1038.
27. Khalid M. Comparison of chromogenic (HiCrome urinary tract infection agar) medium with cysteine lactose electrolyte deficient agar in a resource-limited setting. Int J Appl Basic Med Res 2021;11(1):9-13.
28. Rajaratnam A, Baby NM, Kuruvilla TS, Machado S. Diagnosis of asymptomatic bacteriuria and associated risk factors among pregnant women in Mangalore, Karnataka. J Clin Diagn Res 2014;8:OC23‑25.
29. Mohan B, Gupta P, Appannanavar SB, Singh G, Taneja N. Evaluation of new chromogenic media for identification of uropathogens from complicated urinary tract infections in a tertiary healthcare setting. Indian J Med Microbiol 2015;33:183‑184.
30. Perry JD, Freydiere AM. The application of chromogenic media in clinical microbiology. J Appl Microbiol 2007;103:2046-2055.
31. Yarbrough M.L., Wallace M.A., Marshall C., Mathias E. and Burnham A.-A.D.. 2016. Culture of urine specimens by use of chromID CPS Elite medium canexpedite Escherichia coli identification and reduce hands-on time in the clinical laboratory. J Clin Microbiol 54: 2767-2773.
| Files | ||
| Issue | Vol 14 No 6 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v14i6.11257 | |
| Keywords | ||
| Urinary tract infection; Laboratory; Polymicrobial; Isolation; Identification | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sachu A, Samuel A. Evaluation of chromogenic agar medium, can it be a suitable alternative to conventional culture system for identification of uropathogens?. Iran J Microbiol. 2022;14(6):825-831.
