Growth of non-Campylobacter, oxidase-positive bacteria on selective Campylobacter agar.

A total of 67 oxidase-positive, gram-negative bacteria were tested for growth on selective Campylobacter agar (Blaser formulation, BBL Microbiology Systems, Cockeysville, Md.) at 42 degrees C under microaerophilic conditions. Although the growth of most of these bacteria was prevented, all strains of Achromobacter xylosoxidans, Pseudomonas aeruginosa, Pseudomonas putrefaciens, Pseudomonas alcaligenes, and Pseudomonas pseudoalcaligenes grew as well as Campylobacter fetus subsp. jejuni.     

Multiple selective media for the isolation of anaerobic bacteria from clinical specimens.

Using fresh clinical material, a comparison of a number of anaerobic selective media was made. For Gram-negative anaerobes nalidixic acid tween agar (NAT), neomycin agar (NA), and neomycin-vancomycin agar (NVA) all performed equally well. Kanamycin-containing media were more inhibitory to all Gram-negative anaerobes other than Bacteroides fragilis and B. melaninogenicus. When the recovery of Gram-positive anaerobes was examined NAT performed better than any of the other selective media used. No single selective medium could recover all anaerobes. Better isolation was achieved using a combination of two selective media (the best combinations being NAT and NVA or NAT and NA). Only a combination of three selective media gave the maximum recovery of anaerobes in this study (NAT, NVA, and NA or KA).     

Evaluation of enrichment, storage, and age of blood agar medium in relation to its ability to support growth of anaerobic bacteria.

By measuring the colony size of a variety of anaerobic bacteria isolated from clinical specimens, an evaluation was made of the benefits derived from the addition of several enrichments to blood agar medium commonly used for the growth of anaerobes. Similar methods were used to study the effects of various storage conditions and age of the medium. The results were compared with those obtained on freshly prepared and enriched blood agar plates as well as commercially available blood agar plates. Freshly prepared and enriched blood agar was found to give substantially larger colonies than could be grown on commercially obtained blood agar plates when both were inoculated and incubated under identical conditions. Storage of plating media under CO2 for periods of up to 72 h had only a minor effect on the growth of the anaerobic bacteria studied, but longer periods of storage under CO2 resulted in a less efficient plating medium. Nonenriched brain heart infusion (BHI) was found to be a better basal medium than Trypticase soy agar (TSA) medium. Colony size on fully enriched BHI blood agar plates was greater than nonenriched BHI greater than nonenriched TSA greater than commercially prepared nonenriched TSA plates. The data suggest that freshness of the plates may be as important as using rich media.     

Continuous opacity monitoring of the growth of bacteria under strict anaerobic conditions.

A newly designed instrument is described which generates continuous records of the opacities of six bacterial cultures growing under strict anaerobic conditions. Additions (for example, of antibacterial agents) or withdrawal of culture (for example, for viable counting) can be made at any time without breach of anaerobiosis. Use of the instrument is illustrated by growth curves obtained from small inocula of two strict anaerobes, Bacteroides asaccharolyticus and Peptostreptococcus anaerobius and by the effects on the growth curve of Bacteroides fragilis of adding various concentrations of metronidazole at different times.     

Comparison of four commercial brucella agar media for growth of anaerobic organisms.

Four different commercial brucella blood agar plating media (Anaerobe Systems, BBL Microbiology Systems, Remel, and Scott Laboratories) were compared for the abilities to recover anaerobic organisms from clinical specimens and to support the growth of American Type Culture Collection anaerobic stock cultures. Following 24 h of incubation in an anaerobe chamber, Anaerobe Systems prereduced, anaerobically sterilized brucella plates yielded 63% of the total clinical anaerobe isolates, the Scott medium yielded 51%, the Remel medium yielded 42%, and the BBL medium yielded 37%. Poor growth of Peptostreptococcus magnus, P. anaerobius, Fusobacterium necrophorum, F. nucleatum, and pigmented Bacteroides spp. was observed on brucella media obtained from BBL, Remel, and Scott. Data obtained with stock anaerobic cultures showed that Anaerobe Systems plates yielded good growth and produced a larger colony size with all of the strains tested in 1 day, whereas poor growth of Peptostreptococcus spp., B. melaninogenicus, and Fusobacterium spp. was noted on brucella media from BBL, Remel, and Scott.     

Oxygen tolerance of fresh clinical anaerobic bacteria.

The oxygen tolerance and sensitivity of 57 freshly isolated anaerobic bacteria from clinical specimens was studied. All the organisms tolerated 8 h or more of exposure to oxygen in room air. Growth of the isolates in increasing oxygen concentrations demonstrated that the 57 isolates varied in oxygen sensitivity from strict to aerotolerant anaerobes. Comparison of the oxygen tolerance and sensitivity showed that the most tolerant organisms (best survival after prolonged exposure) included anaerobes capable of growth at only 0.4% or less O2 (strict) as well as those able to grow in as much as 10% O2. The least tolerant were predominately strict anaerobes. Decrease in the inoculum size from a concentration of 10(8) to 10(6) colony-forming units per ml had only a minor effect. The data indicate that the brief oxygen exposure with bench techniques in clinical laboratories would not be deleterious to the anaerobic bacteria present in clinical specimens.     

Recovery of anaerobic, facultative, and aerobic bacteria from clinical specimens in three anaerobic transport systems.

With aspirated specimens from clinical infections, we evaluated the recovery of anaerobic, aerobic, and facultative bacteria in three widely used transport systems: (i) aspirated fluid in a gassed-out tube (FGT), (ii) swab in modified Cary and Blair transport medium (SCB), and (iii) swab in a gassed-out tube (SGT). Transport tubes were held at 25 degrees C and semiquantitatively sampled at 0, 2, 24, and 48 h. Twenty-five clinical specimens yielded 75 anaerobic strains and 43 isolates of facultative and 3 of aerobic bacteria. Only one anaerobic isolate was not recovered in the first 24 h, and then, only in the SGT. At 48 h, 73 anaerobic strains (97%) were recovered in the FGT, 69 (92%) in the SCB, and 64 (85%) in the SGT. Two problems hindered the recovery of anaerobes in the SCB and SGT systems: first die-off of organisms, as evidenced by a decrease in colony-forming units of 20 strains (27%) in the SCB and 25 strains (33%) in the SGT, as compared with 7 strains (9%) in the FGT, over 48 h; and second, overgrowth of facultative bacteria, more frequent with SCB and SGT. The FGT method was clearly superior at 48 h to the SCB and SGT systems in this study and is recommended as the preferred method for transporting specimens for anaerobic culture.     

Effect of storage conditions of the performance of bismuth sulfite agar.

Refrigerated storage of bismuth sulfite agar plates for up to 4 days did not adversely affect growth and colonial characteristics of selected Salmonella strains. Incubation of inoculated plates for 48 h favored the development of more salmonellae with typical morphology. Inoculated plates of freshly poured medium incubated for 48 h gave recoveries similar to those on refrigerated plates and showed a high selectivity against Citrobacter freundii and Proteus vulgaris, organisms which mimic the colonial characteristics of Salmonella on this medium. The use of bismuth sulfite plates stored at room temperature for more than 2 days should be avoided.     

Evaluation of the Vitek 2 ANC card for identification of clinical isolates of anaerobic bacteria

An evaluation of the Vitek 2 ANC card (bioMérieux, Marcy l'Etoile, France) was performed with 301 anaerobic isolates. Each strain was identified by 16S rRNA gene sequencing, which is considered to be the reference method. The Vitek 2 ANC card correctly identified 239 (79.4%) of the 301 clinical isolates to the genus level, including 100 species that were not represented in the database. Correct species identification was obtained for 60.1% (181/301) of the clinical isolates. For the isolates not identified to the species level, a correct genus identification was obtained for 47.0% of them (47/100), and 16 were accurately designated not identified. Although the Vitek 2 ANC card allows the rapid and acceptable identification of the most common clinically important anaerobic bacteria within 6 h, improvement is required for the identification of members of the genera Fusobacterium, Prevotella, and Actinomyces and certain Gram-positive anaerobic cocci (GPAC).     

A comparison of selective media for the isolation of anaerobic bacteria from clinical material

Clinical specimens submitted for anaerobic culture to a Melbourne teaching hospital microbiology laboratory were plated onto 3 types of selective media, to determine which would allow the optimal recovery of anaerobic organisms. The 3 media employed were kanamycin agar (KA), neomycin agar (NA) and nalidixic acid-Tween 80 agar (NAT). The highest isolation rate was achieved on NAT, 89% of the total of all anaerobes isolated being recovered on this medium. A recovery rate of 69% was achieved using NA, while use of KA allowed the isolation of only 56% of all strains. The major difference between 3 media was in the recovery of anaerobic Gram-positive cocci, which accounted for 40% of the total isolates on NAT, 25% on NA, and only 11% on KA. The NAT was also more successful in the isolation of Fusobacterium and Veillonella species. The NAT medium failed, however, to recover Clostridium spp. that were isolated on both NA and KA. There was no significant difference between the 3 media in regard to the recovery of Bacteroides spp.     

Superoxide dismutase in anaerobic bacteria of clinical significance.

Twenty-two anaerobic bacteria isolated from infected sites and normal fecal flora were assayed for superoxide dismutase (SOD). The organisms were also classified according to their oxygen tolerance into aerotolerant, intermediate, and extremely oxygen-sensitive groups. There was a correlation between the enzyme level and the oxygen tolerance, in that the aerotolerant and intermediate organisms had SOD, whereas the extremely oxygen-sensitive isolates had low or undetectable enzyme. Among the oxygen-tolerant organisms, gram-negative bacteria had higher levels of SOD than gram-positive organisms. Oxygen was shown to induce SOD production in a strain of Bacteriodes fragilis grown in minimal medium under continuous-culture conditions. Enzyme levels in this isolate grown under static conditions were lower in minimal medium than in complex medium, indicating that other components in the complex medium were stimulating the production of SOD. Our data suggest that the variation in oxygen tolerance of anaerobes is usually related to their level of SOD. It is postulated that SOD may be a virulence factor that allows pathogenic anaerobes to survive in oxygenated tissues until the proper reduced conditions are established for their growth.     

Growth and phenotypic characterization of Legionella species on semisolid media made with washed agar.

Legionella pneumophila (and 28 Legionella species) grew efficiently on charcoal-free, buffered yeast extract medium made with washed agar and without apparent loss of infectivity for U937 cells. Because charcoal-free, buffered yeast extract is transparent, it is a suitable base for indicator media and pigment detection. In standard media, charcoal apparently prevents agar contaminants from inhibiting Legionella growth.     

Polymorphonuclear neutrophil chemotaxis under aerobic and anaerobic conditions.

The motility of human polymorphonuclear neutrophils was studied in vitro under aerobic and anaerobic conditions. Chemotactic factors were generated from plasma with immune complexes or with whole bacteria (Staphylococcus aureus, Escherichia coli, and Bacteroides fragilis). Chemotaxis induced by chemotactic factors generated from immune complexes was identical under both conditions. However, chemotaxis utilizing chemotactic factors generated from bacteria was markedly depressed under anaerobic conditions. Mean random tubemoltility was not significantly different under aerobic and anaerobic conditions. These data indicate that different metabolic pathways may be involved in polymorphonuclear neutrophil movement. Some of these pathways require oxygen (chemotaxis in response to factors generated by bacteria in plasma), whereas others do not (random tube migration and chemotaxis in response to factors generated by immune complexes in plasma). These observations may be important in the induction of inflammatory responses within hypoxic tissues.     

Antibiotic susceptabilities of Pseudomonas aeruginosa isolates derived from patients with cystic fibrosis under aerobic, anaerobic, and biofilm conditions

Recent studies have determined that Pseudomonas aeruginosa can live in a biofilm mode within hypoxic mucus in the airways of patients with cystic fibrosis (CF). P. aeruginosa grown under anaerobic and biofilm conditions may better approximate in vivo growth conditions in the CF airways, and combination antibiotic susceptibility testing of anaerobically and biofilm-grown isolates may be more relevant than traditional susceptibility testing under planktonic aerobic conditions. We tested 16 multidrug-resistant isolates of P. aeruginosa derived from CF patients using multiple combination bactericidal testing to compare the efficacies of double and triple antibiotic combinations against the isolates grown under traditional aerobic planktonic conditions, in planktonic anaerobic conditions, and in biofilm mode. Both anaerobically grown and biofilm-grown bacteria were significantly less susceptible (P < 0.01) to single and combination antibiotics than corresponding aerobic planktonically grown isolates. Furthermore, the antibiotic combinations that were bactericidal under anaerobic conditions were often different from those that were bactericidal against the same organisms grown as biofilms. The most effective combinations under all conditions were colistin (tested at concentrations suitable for nebulization) either alone or in combination with tobramycin (10 microg ml(-1)), followed by meropenem combined with tobramycin or ciprofloxacin. The findings of this study illustrate that antibiotic sensitivities are dependent on culture conditions and highlight the complexities of choosing appropriate combination therapy for multidrug-resistant P. aeruginosa in the CF lung.     

Identification of clinical isolates of anaerobic bacteria using matrix-assisted laser desorption ionization-time of flight mass spectrometry

We evaluated the use of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF) for the rapid identification of anaerobic bacteria that had been isolated from clinical specimens and previously identified by 16s rRNA sequencing. The Bruker Microflex MALDI-TOF instrument with the Biotyper Software was used. We tested 152 isolates of anaerobic bacteria from 24 different genera and 75 different species. A total of 125 isolates (82%) had Biotyper software scores greater than 2.0 and the correct identification to genus and species was made by MALDI-TOF for 120 (79%) of isolates. Of the 12 isolates with a score between 1.8 and 2.0, 2 (17%) organisms were incorrectly identified by MALDI-TOF. Only 15 (10%) isolates had a score less than 1.8 and MALDI-TOF gave the wrong genus and species for four isolates, the correct genus for two isolates, and the correct genus and species for nine isolates. Therefore, we found the Bruker MALDI-TOF MicroFlex LT with an expanded database and the use of bacteria extracts rather than whole organisms correctly identified 130 of 152 (86%) isolates to genus and species when the cut-off for an acceptable identification was a spectrum score ≥1.8.     

Differential production of slime under aerobic and anaerobic conditions.

A series of 37 clinical isolates of coagulase-negative staphylococci previously identified as negative for slime production by the tube test were reexamined by the tissue culture plate test under aerobic and anaerobic conditions. None of the strains produced slime under anaerobic conditions; however, five strains (13%) produced slime under aerobic conditions.     

Simple disk technique for detection of nitrate reduction by anaerobic bacteria.

The laboratory and clinical evaluation of a potassium nitrate-saturated disk for the rapid detection of nitrate reductase production in anaerobes was investigated. The optimal disk concentration and incubation time were determined by utilizing triplicate sets of quadrant plates prepared with supplemented brucella (Difco) blood agar and swabbed with a 24-h broth (BBL; 135 C thioglycolate) suspension of the test organism. Each set of plates received one control disk and three disks of varying concentrations of potassium nitrate (1 to 8 mg) with 0.1% sodium molybdate. All sets were incubated in GasPak jars for 24, 48, or 72 h, and subsequently sulfanilic acid and 1,6-Cleve's acid were added to each disk. A pink or red color change was indicative of nitrate reductase production. Eighty-eight stock isolates, 23 American Type Culture Collection strains, and 214 fresh clinical isolates were evaluated and compared with results obtained with tubes of preduced indole-nitrite medium (BBL) incubated for 7 to 10 days. The 6-mg disk incubated for 48 h yielded an overall agreement of 89% with the conventional tube technique, and fresh clinical isolates demonstrated better disk-tube agreement (93%) than previously frozen stock strains. The simplicity and ease of this disk test suggest its value as a preliminary screening procedure for nitrate reductase production. There were no false positives. Negative results by disk should be rechecked by tube.     

Phospholipid composition of gliding bacteria: oral isolates of Capnocytophaga compared with Sporocytophaga.

The distribution of acetone-soluble (neutral glycolipid) and acetone-insoluble (phospholipid isoprenoids) lipids in oral isolates of gram-negative gliding bacteria of the genus Capnocytophaga was compared with those in a non-host-related gliding bacterium, Sporocytophaga myxococcoides. The acetone-soluble material accounted for 34 to 55% of the extracted lipids; the remainder was acetone-insoluble material. The major phospholipid was phosphatidylethanolamine (67%), with lesser amounts of lysophosphatidylethanolamine and several unidentified phosphate-containing compounds. Capnocytophaga also contained significant amounts of an ornithine-amino lipid.     

Effect of the growth of anaerobic bacteria on the surface pH of solid media.

Changes in surface pH occurring after varying periods of anaerobic incubation were measured for a total of 23 test solid media. There was little change in the surface pH of uninoculated plates, but plates inoculated with Bacteriodes fragilis showed a striking fall in pH, to pH 5 in the case of some of the test media. The problems of controlling the surface pH of solid media are discussed and possible methods of control are considered.