CHROMID. Reading Guide

Transcription

1 CHROMID Reading Guide

2 CHROMID Reading Guide 2018 biomérieux, Inc. BIOMERIEUX, he BIOMERIEUX logo, and CHROMID are used, pending and/or regisered rademarks belonging o biomérieux, one of is subsidiaries, or one of is companies. Paens: PRN: This CHROMID reading guide is inended o be a handy, visual aid when reading your chromogenic plaes. CHROMID provides clear, easy o read media ha can be used by rained saff of all skill levels o aid in infecion prevenion effors o conrol he spread of resisance in an insiuion. biomérieux, Inc. is a parner you can work wih o enhance your animicrobial sewardship effors providing faser, more accurae and acionable resuls ha can help improve healh oucomes and deliver measurable downsream savings. CHROMID MRSA CHROMID MRSA/S. aureus CHROMID VRE CHROMID CARBA Noe: Please refer o each produc s insrucion for use documen if you have specific quesions. biomérieux, Inc. 100 Rodolphe Sree Durham, NC USA Tel: (800) CHROMID C. difficile CHROMID STREPTO B CHROMID CPS ELITE CHROMID Candida

3 Inended Use Chromogenic medium for he screening and qualiaive deecion of mehicillin-resisan Saphylococcus aureus (MRSA) CHROMID MRSA MRSA S. aureus ATCC (MRSA) Chromogenic medium for he qualiaive deecion of MRSA from he following sies: Anerior nares swab specimens from paiens and healhcare workers o screen for MRSA colonizaion Skin and skin srucure infecions Posiive blood culures demonsraing Gram-posiive cocci on Gram sain MRSA will appear as green colonies afer 24 hours of incubaion.

4 CHROMID MRSA Proocol Swab specimens from anerior nares, skin and skin srucure infecions and posiive blood culures MRSA CHROMID MRSA 24 hours of incubaion Resuls: Green colonies = MRSA 24 hours incubaion Inerpreaion One or more green colonies Posiive MRSA deeced No green colonies Negaive No MRSA deeced Noe: The green color is more vivid if he colonies are observed hrough he agar wih he plae upside down. CHROMID MRSA Ref (20 plaes)

5 CHROMID MRSA/S. AUREUS Inended Use Chromogenic medium for he screening and qualiaive deecion of mehicillin-resisan Saphylococcus aureus (MRSA) and chromogenic medium for he selecive isolaion of saphylococci and he direc idenificaion of S. aureus on a bi-plae CHROMID MRSA agar (MRSA) for he qualiaive deecion of MRSA from he following sies: Anerior nares swab specimens from paiens and healhcare workers o screen for MRSA colonizaion Skin and skin srucure infecions Posiive blood culures demonsraing Gramposiive cocci on Gram sain AND CHROMID S. aureus (SAID) for selecive isolaion of saphylococci and idenificaion of S. aureus from: Anerior nares swab specimens from paiens and healhcare workers o screen for MRSA colonizaion Skin and skin srucure infecions AND S. aureus ATCC S. aureus ATCC MRSA/ SAID

6 CHROMID MRSA/S. AUREUS Proocol Swab specimens from anerior nares, skin/skin srucure infecions and blood culures MRSA/ SAID CHROMID MRSA/SAID hours of incubaion MRSA = Green colonies SAID = S. aureus are green colonies Observe he colonies hrough he agar wih he plae upside down. The green color is more vivid. Noe: If negaive resuls are obained afer 24 hours on CHROMID S. aureus agar, he medium can be incubaed for an addiional 24 hours in order o increase he sensiiviy of deecion of S. aureus. In his case, any green colonies mus be idenified using supplemenary ess. Noe: If incubaing he plaes for an addiional 24 hours, DO NOT read he MRSA side of he plae. CHROMID MRSA/SAID Ref (20 plaes)

7 CHROMID VRE Inended Use Selecive chromogenic medium for he deecion of Enerococcus faecium and Enerococcus faecalis showing acquired vancomycin resisance (VRE) E. faecalis ATCC E. faecium ATCC VRE CHROMID VRE conains wo chromogenic subsraes α-glucosidase & ß-galacosidase and vancomycin (8mg/l) which enable isolaion & deecion of acquired vancomycin-resisan enerococci. Characerisic coloraion of colonies wih: Viole color = E. faecium Blue-o-Green color = E. faecalis

8 CHROMID VRE Proocol Screening Specimen (Sool and recal swabs) CHROMID VRE 24 hours of incubaion VRE Resuls: Blue-o-Green = Vancomycin-resisan E. faecalis Viole color = Vancomycin-resisan E. faecium A posiive resul may be obained afer 24 hours of incubaion, however, if he plaes have a negaive resul (no growh or no viole or blue-o-green pigmened colonies), incubaion mus be exended for an addiional 24 hours for a oal of 48 hours incubaion. CHROMID VRE Ref (20 plaes)

9 Inended Use CHROMID CARBA Selecive chromogenic medium for he isolaion of Carbapenemase-Producing Enerobaceriaceae (CPE). CPE are muli-resisan baceria ha are capable of causing nosocomial infecions and hospial oubreaks E. coli Klebsiella pneumoniae ATCC BAA-1705 CARB Pink o burgundy colonies = E. coli species Blue-green o bluish grey colonies = KESC group (Klebsiella, Enerobacer, Serraia, Cirobacer)

10 CHROMID CARBA Proocol CHROMID CARBA hours of incubaion Pink o burgundy colonies = E. coli species Blue-green o bluish grey colonies = KESC group (Klebsiella, Enerobacer, Serraia, Cirobacer) CARB Noe: Idenificaion of he microorganism mus be followed by addiional ess and carbapenemase producion mus be confirmed. CHROMID CARBA Ref (20 plaes)

11 Inended Use CHROMID C. DIFFICILE Chromogenic medium for he deecion and idenificaion of Closridium difficile Closridium difficile ATCC BAA2155 CDIF C. difficile colonies are grey o black wih an irregular or smooh border.

12 CHROMID C. DIFFICILE Proocol Sool Specimens of Sympomaic Paiens CHROMID C. difficile 24 hours of incubaion in anaerobic condiions a 37 degrees C. difficile colonies are grey o black wih an irregular or smooh border. CDIF Appropriae ess should be performed on he specimen o confirm Closridium difficile infecion. CHROMID C. difficile Ref (20 plaes)

13 Inended Use Selecive chromogenic medium for he screening of group B srepococci (S. agalaciae) CHROMID STREPTO B ATCC S. agalaciae STRB Specific chromogenic medium for prenaal GBS screening Deecion of GBS srains, including non ß-hemolyic srains Pale pink o red colonies = GBS

14 CHROMID STREPTO B Proocol Vaginal/recal swabs from pregnan woman Enrichmen sep - LIM broh hours incubaion CHROMID STREPTO B Resuls: 24 hours of incubaion 24 hours incubaion Inerpreaion One or more pale pink o red in color colonies a 24 hours confirmed by biochemical or laboraory es Posiive GBS deeced STRB No growh or no pale pink o red in color colonies a 24 hours Negaive No GBS deeced CHROMID STREPTO B Ref (20 plaes)

15 Inended Use Isolaion, enumeraion and direc or presumpive idenificaion of urinary rac infecion organisms CHROMID CPS ELITE Proeus mirabilis E. coli Enerococci CPSE/ CPSO Idenificaion of polymicrobial mixures

16 CHROMID CPS ELITE Mehodology E. coli Red o burgundy colonies ß-glucuronidase + ß-galacosidase +/- E. coli P. mirabilis Ligh brown o dark brown colonies deaminase + Proeeae Deecion of Indole Indole + Proeus, Morganella, Providencia Indole - Proeus mirabilis Cocci Enerococcus Enerococcus Turquoise colonies ß-glucosidase + Direc examinaion Bacilli Follow up idenificaion CPSE/ CPSO

17 Inoculaion wih a 10-µl calibraed loop Incubaion hours Coun he colonies on he plae CHROMID CPS ELITE Microbial Semi-Quaniaive Enumeraion The heoreical concenraion of baceria is obained by muliplying he number of colonies on he plae by a diluion facor of 1000 (example: 10 colonies correspond o 10 4 CFU/mL) CFU/mL 10 4 CFU/mL CPSE/ CPSO 10 5 CFU/mL 10 6 CFU/mL

18 CHROMID CPS ELITE Saphylococcus saprophyicus Small ligh pink colonies Klebsiella pneumoniae Green o brownish green colonies Colony Idenificaion char *Red o burgundy = E. coli (direc id) Small urquoise or pale blue o green = genus Enerococcus (presumpive id) Blue o green = KESC group (presumpive id) Brown diffuse or brown halo = Proeeae (presumpive id) Small ligh pink = S. saprophyicus (presumpive id) Bluish viole o viole = S. agalaciae (presumpive id) Noe: Idenificaion of he microorganism isolaed mus be followed by addiional ess. I is recommended o perform a Gram sain if biochemical ess are used for he genus Enerococcus or KESC group. * Some srains of E. coli ha show no ß-GUR or ß-GAL aciviy, produce a pale pink o pink color. CPSE (ranslucen medium) Ref (100 plaes) Ref (20 plaes) CPSO (opaque medium) Ref (100 plaes) Ref (20 plaes) CPSE/ CPSO

19 Inended Use Chromogenic medium for he selecive isolaion of yeass and he direc idenificaion of Candida albicans CHROMID CANDIDA Candida ropicalis ATCC 9968, Candida lusianiae and Candida kefyr Candida albicans ATCC Pale blue o dark blue colonies = Candida albicans Pink colonies = Candida ropicalis, Candida lusianiae and Candida kefyr Creamy-whie = no predicive value CAN2

20 CHROMID CANDIDA Proocol All Types of Specimens CHROMID Candida hours of incubaion Resuls: Pale blue o dark blue colonies = Candida albicans *Pink colonies = Candida ropicalis, Candida lusianiae and Candida kefyr *Creamy-whie = no predicive value *Idenificaion of he microorganism isolaed mus be followed by biochemical and/or immunological ess. Take ino accoun he characerisic appearance of filamenous fungi and Candida krusei. CHROMID CANDIDA Ref (20 plaes) CAN2