ChromID C. difficile Agar의 Clostridium difficile 배양 평가
Evaluation of a ChromID C. difficile Agar for the Isolation of Clostridium difficile
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초록
배경: Clostridium difficile는 항생제 관련 설사의 주요한 병인균이며 가장 흔한 원내 감염성 설사의 가장 흔한 원인이다. 최근 C. difficile 감염이 증가하는 추세이며 새로운 고병원성 균주가 나타나고 있어 정확하고 빠른 진단이 필요하다. 본연구에서는 기존의 선택배지인 C. difficile Selective Agar (CDSA; BD, USA)와 chromID C. difficile (chromID CD, bio-Meriéux, France) 배지의 배양률을 비교하였다. 방법: 2011년 7월부터 8월까지 세브란스병원 입원 환자 중 CDI가 의심되어 C. difficile 배양이 의뢰된 738 검체를 알코올처리하여 C. difficile selective agar에 접종한 후, 혐기성 조건(Forma Scientific, USA)으로 37oC에서 48시간 동안 배양하였다. 배양 24시간, 48시간 후에 각각 판독하였고, CDSA에 자란 균이 있는 경우 −20oC에 냉동 보관된 검체를 찾아서 일주일에 1회 chromID C. difficile agar에 재접종하였다. 총 104검체를 재접종하였고, 같은 조건으로 배양하여 배양 24시간,48시간 후에 각각 판독하였다. 동정은 집락의 전형적인 색과 형태 그리고 ATB 32A (API System SA, France)를 이용하였다. 결과: C. difficile 분리율은 chromID CD와 CDSA에서 24시간 배양 후 각각 77.5%와 30.1%, 48시간 배양 후 98.6%와 77.5%로 나타났다. ChromID CD의 경우 C. difficile 집락이 전형적인 검정 또는 회색의 테두리가 불규칙한 모양으로 나타나감별이 쉬운 장점이 있었다. 결론: C. difficile 배양률은 CDSA보다 chromID CD 배지가 우수하였고, 배양 24시간에 C. difficile을 쉽고 빠르게 배양할수 있어 CDSA를 대체할 수 있는 배지로 생각되었다.
Abstract
Background: Clostridium difficile is the main etiologic agent of antibiotic-associated diarrhea and the most common cause of hospital-acquired diarrhea. Recently, the incidence of C. difficile infections (CDI) has increased and new highly virulent C. difficile strains have emerged. Therefore, accurate and rapid diagnosis is needed. We compared the results of using chromID C. difficile (chromID CD, bioMeriéux, France) with the conventional C. difficile Selective Agar (CDSA; BD, USA) for the isolation of C. difficile. Methods: A total of 738 stool specimens of suspected CDI patients at the Severance Hospital from July to August 2011 were inoculated onto CDSA. Among them, 104 stool specimens revealed colonies on CDSA that were then re-inoculated onto chromID CD. The stool samples were stored at −20oC until the time of the re-inoculation. Cultured agars were interpreted after 24 hrs and 48 hrs, respectively. Species identification was performed on the basis of colony characteristics on agar plates as well as the ATB 32A system (API System SA, France). Results: The recovery rates of CDSA and chromID CD were 30.1% and 77.5% after 24 hrs, and 77.5% and 98.6% after 48 hrs, respectively. All of the C. difficile isolates were recovered as typical gray/black colonies on chromID CD. Conclusion: The performance of chromID CD for the isolation of C. difficile was better than that of conventional CDSA. The chromID CD could provide easy and sensitive detection of C. difficile even after 24hrs of incubation.
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