title: Rapid isolation and susceptibility testing of Leptospira spp. using a new solid medium, LVW agar.
abstract: Pathogenic Leptospira spp., the causative agents of leptospirosis, are slow-growing Gram-negative spirochetes. Isolation of Leptospira from clinical samples and testing of antimicrobial susceptibility are difficult and time-consuming. Here, we describe the development of a new solid medium that facilitates more-rapid growth of Leptospira spp. and the use of this medium to evaluate the Etest's performance in determining antimicrobial MICs to drugs in common use for leptospirosis. The medium was developed by evaluating the effects of numerous factors on the growth rate of Leptospira interrogans strain NR-20157. These included the type of base agar, the concentration of rabbit serum (RS), and the concentration and duration of CO(2) incubation during the initial period of culture. The highest growth rate of NR-20157 was achieved using a Noble agar base supplemented with 10% RS (named LVW agar), with an initial incubation at 30°C in 5% CO(2) for 2 days prior to continuous culture in air at 30°C. These conditions were used to develop the Etest for three species, L. interrogans (NR-20161), L. kirschnerii (NR-20327), and L. borgpetersenii (NR-20151). The MICs were read on day 7 for all samples. The Etest was then performed on 109 isolates of pathogenic Leptospira spp. The MIC(90) values for penicillin G, doxycycline, cefotaxime, ceftriaxone, and chloramphenicol were 0.64 units/ml and 0.19, 0.047, 0.5, and 2 μg/ml, respectively. The use of LVW agar, which enables rapid growth, isolation of single colonies, and simple antimicrobial susceptibility testing for Leptospira spp., provides an opportunity for new areas of fundamental and applied research.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand.
authors.forename: Vanaporn
authors.initials: V
authors.lastname: Wuthiekanun
authors.forename: Premjit
authors.initials: P
authors.lastname: Amornchai
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Paris
authors.forename: Sayan
authors.initials: S
authors.lastname: Langla
authors.forename: Janjira
authors.initials: J
authors.lastname: Thaipadunpanit
authors.forename: Wirongrong
authors.initials: W
authors.lastname: Chierakul
authors.forename: Lee D
authors.initials: LD
authors.lastname: Smythe
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: White
authors.forename: Nicholas P J
authors.initials: NP
authors.lastname: Day
authors.forename: Direk
authors.initials: D
authors.lastname: Limmathurotsakul
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
mesh_terms: D000362:Agar; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002245:Carbon Dioxide; D015169:Colony Count, Microbial; D003470:Culture Media / Q000737:chemistry*; D006801:Humans; D007921:Leptospira interrogans / Q000187:drug effects* / Q000254:growth & development* / Q000302:isolation & purification / Q000472:pathogenicity; D007922:Leptospirosis / Q000188:drug therapy / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D011817:Rabbits
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media; D002245:Carbon Dioxide; D000362:Agar