HiCrome™ UTI Agar

Intended Use:

Recommended for presumptive identification and confirmation of microorganisms mainly causing urinary tract infections.

Composition**

Final pH (at 25°C) 6.8±0.2

**Formula adjusted, standardized to suit performance parameters

Directions

Suspend 56.8 grams in 1000 ml purified/distilled water. Heat to boiling to dissolve the medium completely. Sterilize by autoclaving at 15 lbs pressure (121°C) for 15 minutes. Cool to 45-50°C. Mix well and pour into sterile Petri plates.

Principle And Interpretation

Urinary tract infections are bacterial infections affecting parts of urinary tract. The common symptoms of urinary tract infection are urgency and frequency of micturition, with associated discomfort or pain. The common condition is cystitis, due to infection of the bladder with a uropathogenic bacterium, which most frequently is Escherichia coli, but sometimes Staphylococcus saprophyticus or especially in hospital-acquired infections, Klebsiella species, Proteus mirabilis, other coliforms, Pseudomonas aeruginosa or Enterococcus faecalis (1). HiCrome™ UTI Agar is formulated on basis of work carried out by Pezzlo (2) Wilkie et al (3), Friedman et al (4), Murray et al (5), Soriano and Ponte (6) and Merlino et al (7). HiCrome™ UTI Agar (M1353R) is similar to M1353 with a slight difference in chromogenic mixture to improve the colour characteristic of media. These media are recommended for the detection of urinary tract pathogens where HiCrome™ UTI Agar has broader application as a general nutrient agar for isolation of various microorganisms. It facilitates and expedites the identification of some gram-negative bacteria and some gram-positive bacteria on the basis of different contrasted colony colours produced by reactions of genus or species specific enzymes with two chromogenic substrates. The chromogenic substrates are specifically cleaved by enzymes produced by Enterococcus species, E.coli and coliforms. Presence of amino acids like phenylalanine and tryptophan from peptone special helps for detection of tryptophan deaminase activity, indicating the presence of Proteus species, Morganella species and Providencia species. One of the chromogenic substrate is cleaved by β-glucosidase possessed by Enterococci resulting in formation of blue colonies. E.coli produce pink colonies due to the enzyme β-D-galactosidase that cleaves the other chromogenic substrate. Further confirmation of E.coli can be done by performing the indole test. Coliforms produce purple coloured colonies due to cleavage of both the chromogenic substrate. Colonies of Proteus, Morganella and Providencia species appear brown because of tryptophan deaminase activity. Peptone provides nitrogenous, carbonaceous compounds and other essential growth nutrients. This medium can be made selective by supplementation with antibiotics for detecting microorganisms associated with hospital borne infections.

Type of specimen

Clinical samples: urine, faeces, Food samples, Water samples.

Specimen Collection and Handling

For clinical samples follow appropriate techniques for handling specimens as per established guidelines (8,9). For food samples, follow appropriate techniques for sample collection and processing as per guidelines (10). For water samples, follow appropriate techniques for sample collection, processing as per guidelines and local standards.(1) After use, contaminated materials must be sterilized by autoclaving before discarding.

Warning and Precautions

In Vitro diagnostic use. For professional use only. Read the label before opening the container. Wear protective gloves/ protective clothing/ eye protection/ face protection. Follow good microbiological lab practices while handling specimens and culture. Standard precautions as per established guidelines should be followed while handling clinical specimens. Safety guidelines may be referred in individual safety data sheets.

Limitations

1. Individual organisms differ in their growth requirement and may show variable growth patterns on the medium.
2. Each lot of the medium has been tested for the organisms specified on the COA. It is recommended to users to validate the medium for any specific microorganism other than mentioned in the COA based on the user's unique requirement.
3. Since it is an enzyme-substrate based reaction, the intensity of colour may vary with isolates.
4. Further biochemical and serological test are necessary for confirmation.

Performance and Evaluation

Performance of the medium is expected when used as per the direction on the label within the expiry period when stored at recommended temperature.

Quality Control

Appearance White to cream homogeneous free flowing powder

Gelling Firm, comparable with 1.5% Agar gel

Colour and Clarity of prepared medium White coloured, opaque gel with precipitate forms in Petri plates

Reaction Reaction of 5.68% w/v aqueous solution at 25°C. pH: 6.8±0.2

pH 6.60-7.00

Cultural Response

Cultural characteristics observed after an incubation at 35-37°C for 16-24 hours.

Key: *-Corresponding WDCM numbers, # - Formerly known as Enterobacter aerogenes.

Storage and Shelf Life

Store between 15-25°C in a tightly closed container and the prepared medium at 2-8°C. Use before expiry date on the label. On opening, product should be properly stored dry, after tightly capping the bottle in order to prevent lump formation due to the hygroscopic nature of the product. Improper storage of the product may lead to lump formation. Store in dry ventilated area protected from extremes of temperature and sources of ignition. Seal the container tightly after use. Product performance is best if used within stated expiry period.

Disposal

User must ensure safe disposal by autoclaving and/or incineration of used or unusable preparations of this product. Follow established laboratory procedures in disposing of infectious materials and material that comes into contact with clinical sample must be decontaminated and disposed of in accordance with current laboratory techniques (8,9).

Reference

1. Lipps WC, Braun-Howland EB, Baxter TE,eds. Standard methods for the Examination of Water and Wastewater, 24th ed. Washington DC:APHA Press; 2023.
2. Pezzlo M., 1998, Clin. Microbiol. Rev., 1:268-280.
3. Wilkie M. E., Almond M. K., Marsh F. P., 1992, British Medical Journal 305:1137-1141.
4. Friedman M. P. et al, 1991, J. Clin. Microbiol., 29:2385-2389.
5. Murray P., Traynor P. Hopson D., 1992, J. Clin. Microbiol., 30:1600-1601.
6. Soriano F., Ponte C., 1992, J. Clin. Microbiol., 30:3033-3034.
7. Merlino et al, 1995, Abstr. Austr. Microbiol. 16(4):17-3.
8. Isenberg, H.D. Clinical Microbiology Procedures Handbook 2nd Edition.
9. Jorgensen, J.H., Pfaller, M.A., Carroll, K.C., Funke, G., Landry, M.L., Richter, S.S and Warnock., D.W. (2015) Manual of Clinical Microbiology, 11th Edition. Vol. 1.
10. Salfinger Y., and Tortorello M.L., 2015, Compendium of Methods for the Microbiological Examination of Foods, 5th Ed., American Public Health Association, Washington, D.C.