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Bacteriology - gram positive cocci
I am trying to compare the use of a commercial strep A antigen detection kit and the use of the gold standard culture method. Is there any information regarding sensitivity, specificity, reliability, and reproducibility that you could provide me with? also is there any PVP and PVN information that the Society would use for recomendations to labs, clinics and doctor's offices?
(answered 02/16/2005)
Is there an error in the 8th edition of the "Manual of Clinical Microbiology regarding Staph saptophyticus and novobiocin? Table 2 on page 388-389 states that novobiocin resistance positive is "a growth inhibition zone diameter of >/= 16mm with a 5ug novobiocin disc and the text on page 394 states "novobiocin resistance is indicated by an inhibition zone diameter of </= font Walus< Tom Thanks, correct? is Which 16mm?.>
(answered 02/10/2005)
Is group B strep a causative agent for UTI in non-pregnant feamles 18-25 yrs of age?
(answered 12/23/2004)
Is Group B Strep a pathogen in genital cultures from males and non-pregnant females and if it is not, should it just fall under "normal genital flora" and not even be mentioned? Or could a comment be reported saying it is only a pathogen when pregnant?
(answered 12/23/2004)
Our pharmacist said that they had heard recently that the use of Ceftizoxime is not appropriate for Strep pneumoniae - is this true?
(answered 11/02/2004)
If someone tested 2+ MRSA on wound culture is this a lot and does it have to be treated with vancomycin or can it go untreated?
(answered 10/26/2004)
Is it acceptable to perform a caogulase plasma test using staphylococcus species cultured in 5% Sheep blood TSA? I always heard it is not, WHY?
(answered 10/26/2004)
Is catalase and strep grouping result adequate for identifying Strep pyogenes or is is necessary to add the PYR disk?
(answered 10/26/2004)
Should coagulase negative staphs be reported as coag negative staphs or should micro labs report the identification as more of a complete id (example: Staph epidermidis, Staph saprophyticus, etc)?
(answered 10/25/2004)
Staph saprophyticus is a pathogen, but is there a screen you do to R/O other CNS? Otherwise, if you do Id & MIC (Vitek) and get Staph epidermidis, with a colony count of >100,000 col/cc and many WBC's in the UA, I want to report that Staph epidermidis. Any advice?
(answered 10/12/2004)
We are concerned about the increase in Grp B strep that we are seeing in throats. What are other institutions doing when identifying this organism. We are concerned that these are sexually active adults and although not generally an organism to be pathogenic should it be reported when found as the predominant organism in a strep screen culture. We currently report as beta strep non-A.
(answered 10/07/2004)
We got a strain from blood which was identified as rhizobium by VITEK2 with 70% confidence. Any suggestion for further accurate identification.
(answered 10/06/2004)
Hello. Could you please tell me why a gram stain alone is not helpful in identifying mrsa from pus from a wound swab. Thankyou.
(answered 10/01/2004)
We have a Vitek and to differentiate E. gallinarum, E casseliflavus, & E. faecium they recommend a motility at 30degrees. I see that BBL and Remel both offer Motility media but they are intended for motility in enterobacteriacae. Can this media be utilized to perform motility on gram positives as well? What QC is required?
(answered 09/24/2004)
What is a good way to identify autolytic Strep Pneumo from blood cultures? Secondly, is use of e-test strips to test for resistance to penicillin/cephalosporins and susceptibility to vancomycin an acceptable method of determining that an isolate of corynebacteria is most likely c. jekeium?
(answered 09/14/2004)
How should alpha/gamma streptocci that are Bile esculin +, esculin +, pyr and 6.5$ Salt broth negative be reported? Is Strep sp. not pneumoniae acceptable?
(answered 09/08/2004)
Concerning VRE: Does the finding of in-vitro-sensitivity towards tetracyclin really mean a therapeutic option?
(answered 09/03/2004)
What is the latest national average for MRSA?
(answered 08/18/2004)
Since the news of vanco resis not being detected on automated systems arrived, has the CDC discovered anymore instances of VRSA?
(answered 08/16/2004)
CDC recommends the collection of both rectal and vaginal swabs in screening for GBS. They also recommend placing both swabs in the same LIM broth. How well does this work in practice? I am concerned with overgrowth by enterococci, which might obscure the GBS. Thanks in advance. Victor French
(answered 08/10/2004)
How do you induce the growth of nutritionally deficient streptococci and do you perform susceptibility for these organisms?
(answered 07/26/2004)
Is there a good comprehensive review for educational purpose about pathogenesis and therapy of streptococcal resp. staphylococcal toxic shock syndrome?
(answered 07/14/2004)
What kind of test is require to confirm the identification of M. varians (Kocuria varians)?
(answered 06/29/2004)
Could you please tell me about streptococcal equi in humans, how this could be transmitted from horses and what is the line of treatment? thanks
(answered 06/29/2004)
Would you consider Strep "A" or "B" a pathogen in the stool?
(answered 06/21/2004)
Identification of Staph saprophyticus. I am aware that this isolate can yield a false positive reaction with commercial latex coagulation tests (we use such a product and have seen this occur). How reliable is the slide coagulase test in differentiating S.saprophyticus from S.aureus? Latest Manual of Clinical Micro states "most" S.saprophyticus are slide coag negative. I am concerned about mistakenly misidentifying a Staph saprophyticus as a Staph.aureus in urine specimens. Would the tube coagulase be more reliable?
(answered 06/16/2004)
Should Enterococcus sp. be identified by rapid identification (colony morphology, gram stain, and PYR result) from a sterile site? If not, what other tests should be perfomed to differentiate Enterococcus sp. from Lactococcus garvieae?
(answered 05/02/2004)
I would like some information of the Staphychrom coagulase test including where to order if from.
(answered 05/02/2004)
I am looking for a procedure for how to use Methyl-alpha-D-gluco-pyranoside for differentiation of Enterococci.
(answered 04/09/2004)
What is the incubation period for MRSA disease?
(answered 04/08/2004)
For VRE screening/confirmation is a campylobacter agar plate adequate??
(answered 04/07/2004)
Is it necessary to perform susceptibility testing on isolates from nonsterile body sites for Beta Hemolytic Streptococci Group F? Or do they all respond to Penicillin? 
(answered 04/02/2004)
I am looking for a source using pyruvate broth in the identification of Group D Streptococci.
(answered 04/01/2004)
Is there a "quick" or slide test to differentiate between E. faecalis and E. facium? We currently identify as "Enterococcus sp" without further characterization, based on Group D and PYR. We do not use a "combo" MIC panel. Our Infectious Disease physician is satisfied, but I wonder if there is a quick test and your opinion on the need to differentiate.
(answered 04/01/2004)
If a gamma or alpha strep is bile esculin positive, 6.5%NACL negative and Serotypes positive for the Group D antigen with latex agglutination, is it correct to call it Strep Bovis? On the other hand, if it serotypes Group D negative, is it correct to call it a Viridans strep?
(answered 03/22/2004)
Are our current steps appropriate in identifying Enterococcus in urine cultures? 1-growth on SBA 2-wet mount demonstrating cocci in chains 3-catalase neg (occasionally very weak +) 4- positive SF tube. We are considering addition of bile esculin, but what other step(s) to speciate E.faecalis vs E.faecium? 
(answered 03/22/2004)
Do you have any procedures for isolation and purification of N-acetyl glucosamine from Streptococcus pyogenes? 
(answered 03/22/2004)
I have a comment and a question. The comment is regarding the question about a non-hemolytic isolate that was positive for Group B strep by agglutination, but that also tested as Enterococcus. I had a similar experience with a non-hemolytic Group B strep. It tested as CAMP positive, and positive for Group B by latex agglutination. I performed a PYR since this was the first non-hemolytic Group B Strep that we had found. The PYR was positive. We sent the isolate out to the state laboratory. Meanwhile, I finally discovered that the "isolate" was actually a mixture of Group B Strep and enterococcus. The colony morphology was almost identicle. (The state laboratory did not discover our mistake). I find it difficult to differentiate between non-hemolytic Group B Strep and Enterococcus species based on colony morphology. Since we have begun testing soft, catalase negative, non-hemolytic isolates from vaginal/rectal Group B Strep Screens, the majority of the colonies are enterococcus species rather than Gr. B Strep. This causes us a great deal of extra work. Is there any enhancement broth for Gr. B Strep that will suppress enterococcus? Or is there an agar other than sheep's blood that is more selective/differential for Group B Strep? 
(answered 02/11/2004)
What is the significance of Staphylococcus lugdunensis in pure and in mixed cultures? In addition, in what sites or from what sources should this organism be definitively identified and susceptiblity testing be performed?
(answered 02/12/2004)
I am a postgraduate student focused on the epidemiology of S. aureus in Africa. I observed some S. aureus isolates that're penicillin sensitive but resistant to some other antibiotics. A particular isolate was susceptible to penicillin but resistant to ciprofloxacin, kanamycin, gentamycin and streptomycin. Penicillin susceptible, multiresistant S. aureus are rarely reported. Do you find this trend unusual? Is there an explanation for this expression? Are there any reported cases in literature? 
(answered 08/04/2003)
Should microbiologists be called in out of hours to look at the Gram stain of gastric aspirates on neonates (looking for Strep agalactiae)? We do not have a 24 hour service & this test is costing a lot of money.
(answered 07/22/2003)
Sometimes I find an enterococcus faecalis that is ampicillin S and vancomycin R. Should this be very unusual? Must we have the same precautions as with a multiresistent enterococcus?
(answered 07/03/2003)
How should our laboratory identify alpha grey pinpoint colonies that gram stains as Staph and are catalase negative. We encounter them often in urines(usually in quantities >100,000). Currently we are using a flow chart from ASM that utilizes PYR, LAP, Vancomycin susceptibility and growth in 6.5% NaCl. We dont want to miss Aerococcus urinae, but do we need to worry about(or report) Stomatococcus, Gamella or Pediococcus in urines? 
(answered 06/20/2003)
strep a waived test question -Is culture on negative test required in ER setting as it is in the clinical laboratory. 
(answered 06/08/2003)
Hello - I'm a micorbiologist working in Sri Lanka. We have a problem with identification of S aureus in relation to MRSA screening. Routine identification is carried by slide coagulase (using QC'd human plasma) and if negative, with tube coagulase. I recently read that to be called S aureus, the isolate has to be both slide and tube coagulase positive. Is that correct and should we change practice for routine as well. Would doing a DNAse plate be helpful? Staph latex is too expensive for use here. 
(answered 05/28/2003)
The interpretation range for the novobiocin disk is different depending on the reference ( ASM Manual vs Color Atlas Diag. Micro - Koneman et al). Please explain.
(answered 05/12/2003)
The novobiocin disk resistance interpretation zone seems to be different depending on the reference , ie The ASM Man. of Clin.Micro. 7th Ed. pg 274 --> indicates <16mm and the Color Atlas of Diag. Micro 5th Ed., Koneman , et al indicates <12mm. Which is correct ?
(answered 05/12/2003)
optochin test - Is there possibly an error on page 411 of the new ASM Manual of Clin Micro (8th ed.)? It indicates that zones of > 14 mm are indicative of inhibition. Commercial product package insert and the ASM Clinical Micro Procedure Manual state >= 14 mm. So the interpretation of a 14 mm zone size is the problem here. BTW, I checked the 7th ed. and it also states > 14mm. The 6th ed. states >=14 mm. Is it possible I am the first one to notice, or am I missing something here? 
(answered 04/01/2003)
Hello. I have some grampositive, catalase negative, non-haemolytic cocci that are red-pigmented in the primarily culture but they are non-pigmented in the subcultures. I did not find any organism with this characteristics. 
(answered 02/21/2003)
In the Manual of Clinical Microbiology (7th edition) there are 2 PYR tests mentioned. One in Chapter 16 and one in chapter 17. The first refers to pyrrolidonyl arylamidase and the second to pyrrolidonyl aminopeptidase. Are these the same enzymes and will most PYR test detect them both?
(answered 02/21/2003)
Microaerophilic, very slow-growing, black colony-forming gram-positive coccus in chains recovered from blood culture.
(answered 02/21/2003)
What do you report for non-hemolytic strep which group with the latex Group B antigen? Are these organisms really S. agalactiae?
(answered 02/14/2003)
We are revising our sputum culture procedure. We have information on when to work up most pathogens. Are alpha-hemolytic streptococci always worked up for possible pneumococci regardless of amount present?
(answered 01/30/2003)
WE CURRENTLY INOCULATE A TRYPTICASE SOY SHEEP BLOOD AND SXT SHEEP BLOOD AGAR PLATES ON ALL NEGATIVE STREP SCREEN TESTS FOR GROUP A STREPTOCOCI IN THROATS. WE PUT THE TSA BLOOD IN A CANDLE JAR AND THE SXT PLATE IN AN ANAEROBIC ENVIRONMENT. IS THIS OK OR WHAT SHOULD WE DO?
(answered 01/24/2003)
Are most clinical microbiology labs doing gram stain and catalase on obvious colonies of staphylococci before performing the staphylococcal laxtex test?
(answered 01/17/2003)
Re: Group A Strep ID What do you think about using bacitracin disks for the identification of Group A strep? Would you call a strep "Not Group A" based on the resistance to the "A" disk alone?
(answered 12/23/2002)
We had a vancomycin resistant enterococcus that was motility neg but identified as E. avium at 78%. Would this be considered a VRE for the patient?
(answered 12/10/2002)
Is the standard ornithine decarboxylase medium acceptable for use with Staph to ID S. lugdunensis?
(answered 10/02/2002)
How can I use baird parker agar for identification of MRSA?
(answered 09/26/2002)

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