Table 5 Grading of growth, of 19 ESBL A – or AmpC-producing Shigella isolates (n=19) Growth Excellent Good Poor No growth ESBL A AmpC ESBL A AmpC ESBL A AmpC ESBL A AmpC Brilliance ESBL agar 18 1 BLSE agar* – Drigalski 16 1 2 BLSE agar* – Mac Conkey 15 1 3 CHROMagar ESBL 18 1 ChromID ESBL 17 1 1 All ESBL-producing isolates were mixed with a fecal suspension controlled for the absence of Salmonella, Shigella and any other ESBL-producing bacteria, before being inoculated on the screening agars. *BLSE agar is a biplate
consisting of one half of Drigalski agar and one half of MacConkey agar. Table 6 A comparison of the expected and observed result, colour of colonies and sensitivity ChromID ESBL Brilliance ESBL Drigalski selleck inhibitor (BLSE agar) MacConkey (BLSE agar) CHROMagar ESBL Observed /Expected ESBL A -positive 51/51 51/51 50/51 50/51 51/51 Observed/Expected AmpC-positive 32/36 Opaganib cost 31/0 36/36 36/36 23/0 Expected colour of colonies Colourless Colourless Blue White Colourless Colour of Salmonella colonies Colourless (n = 62) Pink (n = 3) Colourless (n = 61) Pink (n = 3) Blue Pale pink Colourless Colour of Shigella sonnei colonies Pink Blue Blue Pale pink Pink Colour of Shigella flexneri colonies Colourless Colourless Blue Pale pink Colourless Sensitivity
(95% CI*) 95% (90.4 - 99.6) 93% (87.6 - 98.4) 99% (96.9 - 100) 99% (96.9 - 100) 85% (77.5 - 92.5) Sensitivity ESBL A (95% CI*) 100% 100% 98% (94.2 - 100) 98% (94.2 - 100) 100% Sensitivity AmpC (95% CI*) 89% (78.8 - 99.2) 83% (70.7 - 95.3) 100% 100% 64% (48.3 - 79.7) A total of 87 ESBL-producing isolates (51 = ESBLA, 36 = AmpC) were inoculated on the four screening agars. BLSE agar is a biplate consisting of two different agars; Drigalski agar and MacConkey agar. The isolates were mixed with a fecal suspension before
inoculation. The expected results are estimated by the manufacturer’s Florfenicol product information. *CI = 95% Confidence interval. ChromID ESBL All of the 87 spiked fecal samples were expected to be detected on ChromID ESBL agar as colourless colonies. All of the 51 isolates carrying ESBLA genotypes, but only 32 of the 36 AmpC isolates were detected (Table 6). The four AmpC isolates that did not grow on ChromID, all carried bla CMY-2. Three Salmonella-isolates made pink colonies while the rest of the growing Salmonella isolates (n=62) produced colourless colonies. Shigella sonnei (n=16) and Shigella flexneri isolates (n=2) produced pink and colourless colonies, respectively. The total sensitivity of ChromID ESBL was 95% (95% CI 90.4-99.6%), the sensitivity for ESBLA was 100%, and the sensitivity for AmpC was 89% (95% CI 78.8-99.2). ChromID ESBL had overall higher graded growth with ESBLA-positive strains than AmpC-positive (Tables 4 and 5).
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