Biochemical Tests 1- Catalase Test: Purpose: It is used to differentiate between Catalase positive-bacteria, such as staphylococci and Catalase negative-bacteria such as streptococci. Principle: Bacterial Catalase Enz. 2 H2O2 2 H2O + O2 (Bubbles) Methods: 1. Slide Method 2. Tube Method 1- Slide Method: Take 1-2 drops of 3% H2O2 on a slide. Mix it with a small quantity of samplebacteria.bacteria. 2- Tube Method: Pour 1-2 drops of 3%hydrogen peroxide (H2O2) into a test tube. Mix it with a small quantity of sample bacteria. Dr. Refat Al-hakimi Results: bubbles production No bubbles production positive Catalase bacteria (Staphylococcus species) negative Catalase bacteria (Streptococcus species) Catalase positive bacteria Staphylococcus species Bacillus Listeria onocytogenes Gonococcus& Meningococcus Vibrio cholerae Campylobacter & shigella Coagulase Test Purpose: It is used to differentiate between Staphylococcus aureus and other Staphylococcus species . Principle Bacterial coagulase Fibrinogen fibrin coagulation (clot) types of coagulase are produced by Staphylococcus Saureus: 1- Free coagulase 2- Bound coagulase Free coagulase: converts fibrinogen to fibrin by activating a coagualse-reacting factor present Oxidase test in plasma. It is detected by clotting in the tube test Dr. Refat Al-hakimi Bound coagulase (clumping factor): converts fibrinogen directly to fibrin without requiring a coagulase-reacting factor. It can be detected by clumping of bacterial cells in the rapid slide test. Methods: A- Slide Method B- Tube Method A- Slide Method 1- Take one drop of human plasma on a slide. 2- Take part of test colony to the slide by a plastic or wooden stickacteria. 3- Mix well and look for Clumping (clots )within 10 seconds. 4- acteria. Results: Clumping or clots within 10 seconds No clumping within 10 seconds coagulase positive coagulase negative S. aureus. other staph. B- Tube test method (detects free coagulase): pour 3-4 drops of human plasma into a test tube. Well Mix it with 12-16 drops of sample bacteria. — incubate the tubes at 35–370C for 6-12 hours and examine hourly. — If the test is still negative, leave the tube at room temperature overnight and examine again. Dr. Refat Al-hakimi + Results: Clumping or clots in tube No clumping in tube Dr. Refat Al-hakimi positive coagulase negative coagulase S. aureus. other staph. DNaseTest Purpose It is used to help in the identification of Staph. aureus The DNase test is useful when plasma is not available to a coagulase test or when the results of a coagulase test are difficult to interpret. Principle Bacterial DNase enzy. DNA DNA hydrolysis (clear zone) Requirements DNA-ase agar. Hydrochloric acid solution 1 mol/l (1N). Method: Inoculate a plate of DNase agar with a test colony. Incubate in 37 ˚C overnight. Cover the surface of the plate with 1 ml/l hydrochloric acid solution. Look for clearing around the colonies within 5 min of adding the acid. + - Results Clearing around the colonies positive DNA-ase Staphylococcus aureus. No clearingaround the colonies Negative DNA-ase Staphylococcus epidermidis Dr. Refat Al-hakimi Bile solubility test Purpose It helps to differentiate Streptococcus Pneumonia (soluble in bile and bile salts), from viridans streptococci (insoluble). Method Mix several colonies in 2 ml sterile physiological saline to give suspension. Divide the suspension between two tubes. In 1st tube; add 2 drops of the sodium deoxycholate reagent and mix. In 2nd tube (negative control); add 2 drops of sterile distilled water and mix. Leave both tubes for 10–15 minutes at 35–37 0C. Look for a clearing of turbidity in the 2nd tube Results Clearing of turbidity No clearing of turbidity Dr. Refat Al-hakimi bile is lysed bile is not lysed Strept. Pneumoniae. viridans streptococci Oxidase Test Purpose: It is used to differentiate between Oxidase and non-oxidase product bacteria. Principle: Bacterial Oxidase Enz. Phenylenediamine Deep purple color Method: puta piece of filter paper in a clean petri dish. Add 2 or 3 drops of oxidase reagent on the filter paper. Take a small quantity of sample bacteriaand Mix it by a wooden stick. Observe for a color change to a deep blue-purple within 10 seconds. Results No color appears within 10 seconds negative Oxidase. Deep blue-purple within 10 seconds positive Oxidase Examples for Oxidase positive Neisseria Pseudomonas Brucella Haemophilus Vibrio campylobacter Dr. Refat Al-hakimi Indole Test Purpose: It is important for identification of enterobacteria. Principle: Bacterial Enzyme Tryptophan(amino acid) Indole production(red ring) Method: Prepare peptone water andInoculate samplein peptone water. Incubate overnight in 37 ˚C. After incubation period, add drops of Kovac’s reagent to the tube. Shake gently and then Observe for a red ring on the surface layer within 10 minutes. -+ Results: Show as red ring Remain as yellow ring Indole positive Escherichia coli Proteus vulgaris Dr. Refat Al-hakimi positive Indole negative Indole Urease Test Purpose: It is important for differentiating between enterobacteria that produce the urease from non- product. Principle: Bacterial Urease Enzyme Urea Ammonia + Carbon Dioxide (Co2) Method: Inoculate a tube of urea agar with a test colony. Incubate in 37 ˚C overnight. Observe after 4 hours for a change in color to pink or red. Results: Bright pink or bright red color Yellow color positive Urease Proteus Klebsiella Dr. Refat Al-hakimi positive Urease negative Urease. Citrate Test Purpose It is used to assist in the identification of Enterobacteria. Principle: This test is based on ability of bacteriainconsumption of citrate as its only source of carbon. Method by using Simmon’s citrate agar (Green color) Prepare slopes of the medium First streak the slope with a saline suspension of the test organism and then stab the butt by using a sterile straight wire . Incubate at 350C for 48 hours. Look for a bright blue color in the medium Results Bright blue No change in colour Dr. Refat Al-hakimi Positive citrate (Klebsiella and citrobacter) Negative citrate Triple Sugar Iron Test (TSI) or Kligler iron agar (KIA) Purpose It is used to differentiate among the members of Enterobacteriaceae (such as E. coli, Salmonella, Shigella, Klebsiella, Enterobacter etc). Principle It differentiates bacteria on their ability to ferment glucose, lactose, and/or sucrose and on their ability to reduce sulfur to hydrogen sulfide gas (H2S). Method Touch the top of a well isolated by a straight inoculating wire colony. Inoculate TSI by first stabbing through center of the medium to the bottom of the tube and then streaking the surface of the agar slant. Incubate the tube for 18‐24 hours at 35oC in an incubator. Read the result by colour of media Notes Red /Red non-inoculated or negative Yellow/Yellow Red /Yellow Dr. Refat Al-hakimi Lactose fermentation(coliform bacteria) Non-lactose fermentation (other enterobacteria) Red /Yellow false result (contamination) SIM agar method (Sulfide-Indole-Motility) Purpose It is used for detection H2S production, Indole production and Motility of the bacteria. Principle In Indole appear red or pink ring in H2S appear blackening (due to ferrous sulphate production) in Motility appear turbidity (due to motile bacteria) Method Inoculate test organism two-thirds into the medium by stabbing. Incubate at 37°C for 18 –24 hours. Examine tubes after incubation for motility and H2S production. After determining motility and H2S production; add 3-4 drops of Kovac’s Reagent. Record result of indole Pink or red color ring Dr. Refat Al-hakimi No color change Positive Negative Indole Indole Escherichia coli in SIM Medium Motile, indole positive and hydrogen sulfide negative positive indole (Escherichia coli and Proteus vulgaris) negative indole (other enterobacteria) Proteus mirabilis in Motile, indole negative and hydrogen sulfide positive H2S positive indole positive Motile positive Proteus vulgaris Escherichia coli All enterobacteria are motile except: Proteus mirabilis Salmonella Typhi Proteus vulgaris Morganella Morganii Vibrio cholera Vibrio parahaemolyticus Dr. Refat Al-hakimi Shigella species non motile Klebsiella pneumoniae Identification of Staphylococcus aureus LABORATORY FEATURES Specimens: 1- Pus 2- swabs from infected sites 3- sputum 4- cerebrospinal fluid 5- blood for culture. 6- Faeces when foodpoisoning is suspected. Microscopic examination Staphylococci are Gram positive cocci graplike clusters also sometimes singly and in pairs They are non-motile and non-capsulate. Culture - Most Staphylococci grow well aerobically and few strains grow anaerobically - Temperature range for growth is 10–42 ºC, with an optimum of 35–37C. A- Blood agar, chocolate (heated blood)agar: - S. aureus produces yellow to cream colonies after overnight incubation - Some strains are beta hemolytic when grown aerobically. - Colonies are slightly raised. Dr. Refat Al-hakimi S.aureus S.epidermidis B- MacConkey agar: - Smaller colonies are produced after overnight incubation at 35–37 ºC. - Most strains are lactose fermenting. C- Mannitol salt agar: - A useful selective medium for isolating S. aureus from faecal specimens when investigating staphylococcal food-poisoning. - It can also be used to screen for nasal carriers. - S. aureus ferments mannitol and is able to grow on agar containing 70–100g/l sodium chloride. - Mannitol salt agar containing 75 g/l sodium chloride . Biochemical tests S. aureus is: - Catalase positive . Dr. Refat Al-hakimi - Coagulase positive. - DNase positive. Novobiocin S.epidermidis -------------------------Susceptible for Novobiocin S. saprophyticus----------------- Resistant for Novobiocin Dr. Refat Al-hakimi Identification of Streptococcus pyogenes LABORATORY FEATURES Specimens: 1- throat swab (avoiding saliva contamination) 2- swabs of pus 3- serous fluid depending on the site of infection 4- blood for culture. Culture media should be inoculated as soon as possible or a swab placed in a tube of silica gel. Microscopic examination - Streptococci are Gram positive cocci arranged in short chains, but also in pairs and singly - Long chains are formed in fluid cultures. - The organisms are non-motile. Culture Blood agar: - S. pyogenes produces betahaemolytic colonies (clear zone of complete haemolysis ) small, colourless, dry, shiny or mucoid colonies. Dr. Refat Al-hakimi - Haemolysis is more marked under anaerobic conditions as seen in colonies growing below the agar surface . Note : Do not use human blood because this may contain unwanted substances such as citrate (e.g. donor blood), antibiotics, or antibodies such as ASO or anti-M protein that could interfere with the growth of S. pyogenes. MacConkey agar: S. pyogenes does not grow on this medium Biochemical tests S. pyogenes is: - Catalase is negative bacitracin S. pyogenes -----------------------Sensitive for bacitracin S.agalactiae----------------------Resistant for bacitracin Serology - ASO antibody in serum is helpful in diagnosing rheumatic fever. Dr. Refat Al-hakimi Identification of Streptococcus pneumoniae LABORATORY FEATURES Specimens: 1234- Sputum. exudate. blood for culture. cerebrospinal fluid. Microscopic examination - S. pneumoniae is a Gram positive elongated (lanceolate) diplococcus also forms short chains. - Pneumococci are capsulated and non-motile . - In Gram stained smears from specimens, the capsule can often be detected as an unstained empty area around the diplococcus . Culture Blood agar: - S. pneumoniae forms translucent or mucoid colonies, 1–2 mm in diameter. - In young cultures the colonies are raised but later become flattened with raised edges, giving them a ringed appearance . - Pneumococci show alpha-haemolysis, i.e. colonies are surrounded by an area of partial haemolysis or green colour in the medium (reduced Hb). Note: When cultured anaerobically on blood agar, some strains of S. pneumoniae show betahaemolysis Dr. Refat Al-hakimi Chocolate and lyzed blood agar: - S. pneumonia grows well on chocolate agar and lyzed blood agar. - Growth is enhanced when incubated in a CO2 enriched atmosphere (candle jar). Biochemical tests S. pneumoniae is: - Catalase negative. - Sensitive to optochin . - Bile soluble. Rapid latex and coagglutination tests to detect capsular pneumococcal antigen Optochin Pneumococci--------------Sensitive to optochin Dr. Refat Al-hakimi Identification of Neisseria meningitidis LABORATORY FEATURES Specimens 123- CSF. blood for culture swabs from haemorrhagic skin lesions . Microscopic examination -N. meningitides is a non-motile gram negative diplococcus arranged in groups. -In smears from specimens, meningococci are found intracellular . Culture - N. meningitides is an aerobe with primary cultures growing best in a moist CO2 enriched atmosphere . - The temperature range of growth is 25–42 ºC with an optimum of 35–37 ºC. - Enriched media are required for isolation. -Specimens should be cultured as soon as possible after collection. - recommend inoculating C.S.F. into cooked meat medium . Blood cultures - Meningococci grow well in Columbia diphasic medium . - Because sodium polyanetholsulphonate (SPS)may be inhibitory to meningococci, may be add sterile 1%gelatinto neutralize the effect of SPS. - Subculture a positive blood culture onto chocolate agar and incubate in CO2. Dr. Refat Al-hakimi Chocolate (heated blood) agar - N. meningitides produces transparent or grey, shiny, 1–2mm colonies . - The colonies of group B meningococci often appear grey-yellow. Note: N. meningitidis also grows on Mueller Hinton agar without add of blood. Biochemical tests N. meningitidis is oxidase --positive Serology - Direct latex agglutination and coagglutination slide antigen tests are available to detect antigens to the main groups of meningococci . Dr. Refat Al-hakimi Identification of Neisseria gonorrhoeae LABORATORY FEATURES Specimens 1- Urethral and cervical exudates. 2- urine (centrifuged) from male patients 3- rectal swab. 4- An eye swab (gonococcal conjunctivitis in newborn is suspected). Microscopic examination - N. gonorrhoeae is a non-motile, non-capsulate gram negative diplococcus, typically seen in pus cells (intracellular) but also extracellularly. - Morphologically gonococci look the same as meningococci. Making smears: a swab should be gently rolled on a slide when making a smear and the preparation methanol-fixed rather than heat-fixed. Culture - N. gonorrhoeae is an aerobe or facultative anaerobe. - It is a fastidious organism Which requires culturing with the minimum of delay. Dr. Refat Al-hakimi - Some strains are unable to survive drying or temperatures below body temperature. - An enriched selective medium such as modified New York City medium or Thayer Martin medium is required to isolate N. gonorrhoeae from urogenital specimens. - Gonococci grow best in a moist carbon-dioxide enriched atmosphere . - Optimum temperature for growth is 35–36 ºC. MNYC medium and Thayer Martinmedium - N. gonorrhoeae grows rapidly producing small, raised, grey or translucent colonies after overnight CO2 incubation . - Examine a gram stained smear of the colonies and perform an oxidase test . Chocolate agar only is available for isolating N. gonorrhoeae. Biochemical tests - N. gonorrhoeae is oxidase positive. Note: Neisseria colonies are strongly oxidase positive and immediately turn deep Purple the reagent of oxidase is rapidly bactericidal (see above). Serology Coagglutination tests for identifying N. gonorrhoeae isolates have been shown to be specific and highly sensitive. Dr. Refat Al-hakimi Identification of Escherichia coli LABORATORY FEATURES Specimens 1- Urine 2- Pus 3- Faeces 4- Cerebrospinal fluid(infants) 5- Blood. Microscopic examination E. coli is a gram negative usually motile rod. Culture - E. coli is a facultative anaerobe. -Optimum temperature for growth is 36–37 ºC with most strains growing over the range18–44 ºC. MacConkey agar and CLED agar: - E. coli is ferments lactose, producing smooth pink colonies on MacConkey agar and yellow colonies on CLED agar. Dr. Refat Al-hakimi CLED XLD and DCA agar: - Yellow colonies are produced on XLD agar. - Growth of E. coli is usually inhibited on DCA agar. XLD Blood agar: Colonies of E. coli may appear mucoid and Some strains are haemolytic. Dr. Refat Al-hakimi Biochemical tests - KIA:----- acid /acid(Y / Y )with gas production and no H2S production. - Indole----------------positive - urine nitrite test------positive. - Citrate and H2S-----negative. - IMViC test------ (+ + _ _) Dr. Refat Al-hakimi Identification of Klebsiella species LABORATORY FEATURES Specimens: 1- Urine. 2- Pus. 3- Sputum . 4- Infected tissue. Microscopic examination Klebsiellae are Gram negative, non-motile, usually capsulated rods. Culture Klebsiellae are facultative anaerobes. Blood agar: Klebsiellae produce large , grey white usually mucoid colonies. Dr. Refat Al-hakimi MacConkey agar and CLED medium: - Most klebsiellae are lactose-fermenting, producing mucoid pink colonies on MacConkey agar and yellow mucoid colonies on CLED medium . Biochemical tests - KIA:--------acid /acid(Y / Y )with gas production& no H2S production. - Citrate-----positive. - Urea -------positive. -Indole------negative. Dr. Refat Al-hakimi Identification of Salmonella species LABORATORY FEATURES Specimens ENTERIC FEVER 1- Blood---- detected during the first ten days of infection. 2- Faeces---detected during the third week of infection 3- Urine ----- isolated from about 25% of patients after the second week of Infection especially from those with urinary schistosomiasis. DIARRHOEAL DISEASE 1- Faeces 2- Blood (during times of fever) BACTERAEMIA - Blood Microscopic examination Salmonella are gram negative rods, actively motile, non-sporing and non-capsulate (exception of S. Typhi that is a capsulated). Culture - Salmonella are facultative anaerobes. - They grow at 37 ºC(an optimum temperature). XLD agar: - H2S producing salmonellae form pink-red colonies with black centres. - Non H2S producing salmonellae form pink-red colonies without black centres Dr. Refat Al-hakimi DCA and MacConkey agar: - Salmonellae produce non-lactose fermenting pale coloured colonies which on DCA, have black centres(H2S-producing salmonellae). Blood agar (subculture): Salmonella produce grey-white ,non haemolytic colonies. Biochemical tests - KIA –---------alkaline/ acid (pink/ yellow),gas production (exception of S. Typhi)and H2S production with S. Typhi. - Urease, lactose and indole ------negative Serological tests Widal test - Ig M antibody immunoassays. - Dr. Refat Al-hakimi Identification of Shigella species LABORATORY FEATURES Specimens: - A fresh faecal specimens may be watery with little blood, mucus, and pus cells also have an alkaline pH unlike amoebic dysentery have an acid PH. Microscopic examination - Shigellae are Gram negative, non-sporing, and non-capsulate rods also non-motile. Culture - Shigellae are facultative anaerobes. - They grow at 37 ºC (an optimum temperature). - A selective medium is required to isolate Shigella species from faeces. XLD agar: - Shigellae produce red-pink colonies without black centres. DCA and MacConkey agar: - Shigellae produce non-lactose fermenting pale coloured colonies. - On prolonged incubation, S. sonnei forms pink colonies. Salmonella-Shigella (SS) agar - Despite its name, this medium is not suitable for isolating shigellae as it is inhibitory to most strains. Biochemical tests - KIA –---------alkaline/ acid(pink/yellow) . - Lactose ------negative (S. sonnei is a late lactose and sucrose fermenter). - H2S----------negative. - Urease -------negative. - Oxidase -----negative. - Citrate -------negative. Dr. Refat Al-hakimi Identification of Proteus LABORATORY FEATURES Specimens 1- Urine 2- Pus 3- sputum. Microscopic examination - They are gram negative pleomorphic rods, actively motile, non-capsulate. - Motility is not as easily observed at 35–37 ºC . Culture Blood agar: When cultured aerobically, most Proteus cultures have a characteristic ‘fishy’odour. Also produce of Swarming on surface of media. Bile salt, alcohol, dying, chemicals and increasing of agar inhibit of swarming. MacConkey, CLED, XLD media: - Proteus produces individual non-lactose fermenting colonies . - Swarming is prevented on MacConkey agar and XLD agarbecause these media contain bile salts. - Swarming is inhibited on CLED agar because it has an electrolyte deficient. Dr. Refat Al-hakimi Biochemical tests - KIA-----alkaline/ acid (pink/ yellow) gas production and H2S production. - Urea----positive rapidly (differentiate it from salmonellae and shigellae). - Phenylalanine deaminase-------positive. - Beta-galactosidase (ONPG) negative. - Indole negative (P. vulgaris is indole positive). Dr. Refat Al-hakimi Identification of Pseudomonas aeruginosa LABORATORY FEATURES Specimens 12345- Pus Urine Sputum Effusions Blood for culture. Microscopic examination - P. aeruginosa is a Gram negative, non-sporing motile rod. - Some strains are capsulate. Culture - P. aeruginosa is an obligatory aerobe. - It is usually recognized by the pigments it produces including pyocyanin a blue-green pigment and pyoverdin (fluorescein) a yellow-green fluorescent. - Cultures have a distinctive smell due to production of 2-minoacetophenone. - P. aeruginosa grows at 35–37 ºC (an optimum temperature). Blood agar: - P. aeruginosa produces large, flat ,spreading colonies which are often Haemolytic and usually (90% of strains) pigment-producing. - The pigments diffuse into the medium giving it a dark greenish-blue colour. - When the culture is left at room temperature ,pigment colour is more intense. Dr. Refat Al-hakimi MacConkey agar and CLED medium: - P. aeruginosa produces pale coloured colonies on MacConkey agar and green colonies on CLED medium. - Compared with blood agar ,pigment production is less marked. Biochemical reactions - KIA-----------pink/ pink (alkaline/ alkaline),no gas and no H2S production. - Oxidase------positive. KIA Dr. Refat Al-hakimi Identification of Haemophilus influenzae LABORATORY FEATURES Specimens 1234- cerebrospinal fluid (CSF.) nasopharyngeal specimens pus blood Specimens must be cultured as soon as possible and not refrigerated. Dr. Refat Al-hakimi Microscopic examination - H. influenzae is a small non-motile Gram negative coccobacillus or short rod. - Long thread-like and pleomorphic forms may be seen in CSF (with pus cells) or following culture. - It is best stained using dilute carbol fuchsin as the counterstain. - The capsule can be demonstrated by using specific antiserum. Culture - H. influenzae grows poorly anaerobically. - Growth is best achieved in a moist CO2 enriched atmosphere. - They grow at 37 ºC (an optimum temperature). - Media must contain haemin or other iron-containing porphyrin and nicotinamide adenine dinucleotide (NAD) or its phosphate (NADP). - The porphyrin requirement is referred to as growth factor X and the NAD or NADP requirement as growth factor V(from s.aureus). - H. influenzae grows on chocolate agar because it contains factors X and V. - the media must be prepared from horse or rabbit blood but no sheep blood. - H. influenzae produces very small colonies on horse or rabbit blood agar (colonies may appear betahaemolytic). Biochemical reactions - They are not used routinely to identify Haemophilus species. Serological tests They are commercially available for the identification of H. influenzae in cultures and specimens by agglutination techniques. Dr. Refat Al-hakimi