title: ABC chromogenic agar: a cost-effective alternative to standard enteric media for Salmonella spp. isolation from routine stool samples.
abstract: Salmonellosis is the second most common cause of bacterial gastroenteritis, yet the yield from routine stool culture is low. Commonly used selective enteric media have poor specificities for salmonella identification, resulting in a high laboratory workload. A special chromogenic medium, ABC agar, is a promising alternative but its cost-effectiveness has not been evaluated in diagnostic laboratories. A collaborative study is therefore undertaken in two district general hospitals laboratories. Routine stool samples (n=866) were subcultured onto ABC agar half plates after selective enrichment in selenite broth. Similarly, 246 and 620 stool samples were subcultured onto desoxycholate lactose sucrose (DCLS) and xylose lactose desoxycholate (XLD) whole agar plates, respectively. Salmonella spp. were isolated from only 14 (1.6%) of stool samples tested. Specificity was significantly higher for ABC (98%) than DCLS (67%) or XLD (78%) agars. Welcan workload units (ABC 4.8, XLD and DCLS both 7.3) and costs per specimen (ABC 1.26 pounds sterling, DCLS 3.81 pounds sterling and XLD 1.83 pounds sterling) were similarly lower with ABC agar. The results indicate that ABC chromogenic agar offers improvements in specificity, workload and costs over conventional enteric media for Salmonella spp. isolation.
authors.affiliation: Department of Medical Microbiology, District General Hospital, Eastbourne, UK. oneill.bill@esht.nhs.uk
authors.forename: W
authors.initials: W
authors.lastname: O'Neill
authors.forename: R P D
authors.initials: RP
authors.lastname: Cooke
authors.forename: H
authors.initials: H
authors.lastname: Plumb
authors.forename: P
authors.initials: P
authors.lastname: Kennedy
mesh_terms: D000362:Agar; D001431:Bacteriological Techniques / Q000379:methods; D002863:Chromogenic Compounds; D003470:Culture Media; D005243:Feces / Q000382:microbiology*; D006801:Humans; D012475:Salmonella / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D002863:Chromogenic Compounds; D003470:Culture Media; D000362:Agar