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Nutrient medium for determining antibiotic susceptibility of legionella pneumophila

IPC classes for russian patent Nutrient medium for determining antibiotic susceptibility of legionella pneumophila (RU 2542390):
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FIELD: biotechnology.

SUBSTANCE: nutrient medium comprises enzyme-autolyzate of cattle spleen, monosubstituted potassium phosphate, disubstituted potassium phosphate, potassium gluconate, mesoinosite, soluble starch, gelatin, L-cysteine, iron (III) sodium salt, high-grade ink and distilled water in a predetermined ratio of components.

EFFECT: invention enables to improve the accuracy of determining of antibiotic susceptibility of cultures of legionellosis causative agent.

3 tbl 8 ex

 

The present invention relates to medical Microbiology, namely to obtain a dense nutrient medium through which you can determine the antibiotic sensitivity of the cultures of the pathogen regionaliza - Legionella pneumophila.

Common environment to determine the antibiotic sensitivity of the vast majority of pathogenic bacterial species is medium Mueller-Hinton (The Oxoid Manual, 1976, p.193) containing, g/l:. agar, Difco - 10; infusion from beef - 300; casein hydrolysate - 17,5; soluble starch - 1,5; distilled water to 1 liter at a pH of 7.4.

However Legionella in the environment, due to the nature of their metabolism, even with the introduction of various additives grow poorly, so the medium Mueller-Hinton for the study of antibiotic sensitivity Legionella is not applied.

A prototype of the selected nutrient medium for the cultivation and selection Legionella environment ά (see WHO. Legionella and the prevention of legionellesis. WC 200. WHO. 2007), which has the following composition, g/l: yeast extract - 10,0; agar, Difco 13,0; charcoal Norit N - 2,0; ACES - 10; alpha Ketoglutarate acid - 1,0; L-cysteine - 0,4; pyrophosphate of iron - 0,25; glycine - 3,0; cycloheximide - 80,0-100.0 mg/l; vancomycin - 1.0 mg/l; polymyxin In 80-100 thousand IU/l; distilled water to 1 liter at a pH of 7.1.

The disadvantage of the prototype is that Legionella are very sensitive to peroxide compounds and the growth of a single virulent cells of the pathogen in the environment is only possible when the environment is highly active adsorbent, blocking the action of free radicals, is the activation of coal, made by special technology.

However, coal is strongly adsorbs many of the antibiotics currently in use, such as ofloxacin, ciprofloxacin, rifampicin, clindamycin, and others (see K. Nilsen, J. V. Bangsborg, N. Hoiby Susceptibility of Legionella to five antibiotics and development of resistance by exposure to erythromycin, ciprofloxacin assay and rifampicin. Diagn. Environ. Infect. Dis., 36 (2000), 43-48).

Therefore, for this reason, the results characterizing antibiotikoustoichivosti cultures of Legionella received on the environment, unreliable as indicators of inhibition Legionella in most cases artificially low.

The technical problem of the invention was to create a new nutrient medium with a high degree of accuracy in determining antibiotikoustoichivosti Legionella pneumophila.

This object is achieved in that the culture medium to determine the antibiotic susceptibility of Legionella pneumophila, including microbiological agar and L-cysteine, added EDTA iron(III) sodium salt, growth stimulants - potassium phosphate one-deputizing and potassium phosphate (disubstituted), and as osmoprotection - metainit and potassium gluconate, at the same time as nutrition in the environment used fermentational spleen cattle what about the livestock and food gelatin, in the following ratio of components, g/l:

Fermentational spleen of cattle 6-8,0
Agar Microbiology 14,0-16,0
Potassium phosphate one-deputizing 1,5-1,7
Potassium phosphate disubstituted 3,3-3,6
Potassium gluconate 2.4 to 2.6 g
Starch soluble 2,4-2,6
Gelatin 2,4-2,6
Metainit 2,4-2,6
L-cysteine 0,3-0,5
EDTA iron (III) sodium salt 0,026 -0,028
Ink high quality 4-6 ml
Distilled water
at pH 7.1 to 1 l

A nutrient medium is prepared as follows. The source materials for the proposed environment (denoted B-2): agar microbiological 14,0-16,0; -cysteine 0.3 to 0.5 and starch soluble 2,4-2,6; as the growth fundamentals take fermentational spleen of cattle of 6.0-8.0 and gelatin food 2,4-2,6; as a buffer, a mixture of phosphate salts: potassium phosphate one-deputizing (KH2PO4) 1.5 to 1.7 and potassium phosphate disubstituted (K2HPO4) 3,3-3,6. Osmoprotection selected metainit 2,4-and 2,6 potassium gluconate 2,4-2,6, and as the source of iron used complex EDTA iron(III) sodium salt 0,026-0,028. To give a medium dark shade, which is clearly visible zone of inhibition growing culture Legionella, use high-quality fine sterile ink 4-6 ml

All of the above components, except for L-cysteine and EDTA iron(III)sodium salt, bring in a container and add to 1 liter of cold distilled water. The mixture is heated in a steam sterilizer and boil for 30 minutes at 100°C with careful stirring. The liquid is then autoclave at 0.5 psi for 20 minutes the result is a Foundation that is stored at a temperature (2-8°C in the refrigerator for 2 years.

If necessary, the preparation of the working environment based melt and enter the number of the other two additives: L-cysteine and EDTA iron(III) sodium salt. The environment in the melted state (45°C) is poured into plastic Petri dishes with a diameter of 90 mm in a volume of 30 ml and thickness is Noah layer of 0.7 see Cups store in an airtight package when the temperature of the refrigerator for 1-2 months.

Basic biological performance of the proposed environment B-2 is determined in comparison with the best for cultivation of Legionella environment BCYEAά. First characterize its sensitivity, germination colonies of Legionella, as well as the effectiveness of the environment (the amount of grown colonies and the development of turf culture) - examples 1, 2, 3, 4, and 5.

Then, using for comparison the same environment ά determine the fundamental suitability of the environment B-2 to determine the antibiotic susceptibility of Legionella cultures using discs with antibiotics (example 6), strips with gradations of antibiotics (example 7) and using the method of serial dilutions of antibiotics in the environment (example 8). In the experiments used the virulent and avirulent strains of Legionella, obtained from the Museum of living cultures Rostov-on-don, anti-plague Institute:

1) L. pneumophila Philadelphia ATS 33152, serogroup 1, LD50 - 4 105M. K. for seawater. pigs (virulent)

2) the same, but avirulent strain

3) L. pneumophila Blumington ADS 33155, 3 serogroup (avirulent)

4) L. pneumophila Chicago ATS 332 215, serogroup 6 (avirulent)

Example 1

For cooking environment using ingredients in the following minimum concentrations, g/l: fermentational spleen of cattle - 5,0; microbiological agar - 2,0; potassium phosphate one-deputizing - 1,0; potassium phosphate disubstituted - 3,0; potassium gluconate - 2,0; soluble starch - 2,0; gelatin - 2,0; metainit - 2,0; L-cysteine - 0,1; EDTA iron(III) sodium salt of 0.01; high quality ink 3 ml; distilled water to 1 l, pH of 7.1.

The composition of the medium comparison ά similar to the above (see prototype).

In this work, we used the standard methods of determining the sensitivity of nutrient media for Legionella. Used standard strain of Legionella - Legionella pneumophyila Philadelphia - 1 - virulent strain, LD 50 - 4 105M. K. for Guinea pigs and three avirulent strain. Preparation of inoculum: crops grown for 2 days on medium ά at 35°C, then washed with potassium phosphate buffer (pH of 7.1).

After that prepare a suspension of cells with a concentration of 1 billion, M. K./ ml, which was diluted to the working concentration of 103m/ml and seeded in a Cup of 0.1 ml, i.e., 100 M. K. Crops incubated for three days at 35°C, count the number of grown colonies, determine the time of their appearance, the degree of atypical morphology legionellas colonies and compare their diameter in different environments at different times of incubation. The sowing was done three times, for comparison using average values. Statistical significance of the similarities and differences of the values determined using Chi-Quadra is.

The results revealed that chuvstvitelnosti both environments statistically differed from 100 sown M. K. Legionella all four strains on the third day of incubation in the medium B-2 composition of example 1 was increased to 20 colonies of the pathogen on the control environment - 50-60 typical colonies of Legionella (p is 0.05, Chi-square 6,0), i.e., the degree of sensitivity of the first environment is insufficient. Similar differences in the time of appearance of colonies on the media - in all cases, the proposed environment they were recorded using a stereomicroscope on the fifth day of incubation, visually on the sixth - in the form of small rosinate colonies up to 1 mm in diameter, stereomicroscopes with typical fine grain and melkopyatnistoy with a greenish glow. On the prototype environment stereomicroscopes colonies of Legionella were registered on the second day, visually - third that meets the standards. Efficiency environment ά was much better than Wednesday B-2 of example 1, i.e., the amount of colonies on 5 days of growth on average in the first environment was 4-5 mm, the second maximum diameter of colonies on 6 days of growth was 2-3 mm. Growth of lawn culture on the prototype environment at inoculation of 0.1 ml of suspension culture Legionella all strains tested after one day of incubation at 35°C was sufficient for its visual check on proposed was extremely weak.

T is thus, Wednesday, prepared according to example 1, does not satisfy the requirements as a diagnostic of nutrient medium for Legionella pneumophila, and cannot be used to determine its antibiotic sensitivity.

Example 2

To prepare the environment used the above ingredients in the following concentrations, g/l: fermentational spleen of cattle - 6,0; microbiological agar - 14,0; potassium phosphate one-deputizing - 1,3; potassium phosphate disubstituted - 3,2; potassium gluconate - 2.3; soluble starch - 2,3; gelatin - 2.3; metainit - 2,3; L-cysteine - 0,3; EDTA iron(III) sodium salt - 0,025; a high quality ink - 4 ml; distilled water to 1 l, pH of 7.1.

Methods to determine and compare the sensitivity, time of germination and the efficiency of the proposed nutrient medium B-2 and ά were identical to those described in example 1.

The results of the comparison of the sown 100 M. K. virulent and avirulent strains of Legionella in both environments was raised on the third day 50-60 typical colonies (p is 0.05, Chi-square - 0,31), the period of formation of colonies - 2 nights when observed through a stereomicroscope and 3 days by visual observation. But the efficiency of growth of colonies on the 5th day of incubation environment ά was somewhat better prepared according to example 2. At the same time, the severity of lawn culture on the environment was quite the full visual check on the 2 days of growth. Thus, the composition of the medium, prepared according to example 2, provides the growth of Legionella to the extent that this environment was considered as corresponding to generally accepted standards of the who.

Example 3

To prepare the environment used the above ingredients in the following concentrations, g/l: fermentational spleen of cattle - 7,0; microbiological agar - 15,0; potassium phosphate one-deputizing - 1,6; potassium phosphate disubstituted - 3,4; potassium gluconate - 2,5; soluble starch - 2,5; gelatin - 2,5; metainit - 2,5; L-cysteine - 0,4; EDTA iron(III) sodium salt - 0,027; ink high-quality - 5 ml; distilled water to 1 l, pH of 7.1.

Methodology a comparative study of the sensitivity and efficiency of both environments consistent with the above. The obtained results (growth 45-65 typical colonies of all tested strains in both environments, the appearance of colonies on 2-3 day incubation at 35°C, sufficient efficiency of colony growth and turf crops with some exceeding these indicators on environment comparisons) indicate that the environment is taken in this part, fully complies with the requirements of diagnostic reference nutrient medium BCYEAά used for the cultivation and selection of Legionella pneumophila. Test environment specified in part on these grounds may be used for the detection of the of the antibiotic susceptibility of Legionella cultures and for normal growth.

Example 4

To prepare the environment used the above ingredients in the following concentrations, g/l: fermentational spleen of cattle - 8,0; microbiological agar - 16,0; potassium phosphate one-deputizing - 1,7; potassium phosphate disubstituted - 3,6; potassium gluconate - 2,6; soluble starch - 2,6; gelatin - 2,6; metainit - 2,6; L-cysteine - 0,5; EDTA iron(III) sodium salt - 0,028; ink high quality 6 ml; distilled water to 1 l, pH of 7.1.

Methodology of comparative study of the above indicators of both environments corresponded described. The obtained results (growth 50-65 typical colonies of all tested strains in both environments, the appearance of colonies on 2-3 day incubation at 35°C, sufficient efficiency of colony growth and turf crops with some exceeding these indicators on environment comparisons) indicate that the environment is taken in this part, fully complies with the requirements of diagnostic reference nutrient medium BCYEAά used for culturing and selection Legionella. The test environment in this composition on the above grounds may be used for detection of antibiotic susceptibility of Legionella pneumophila cultures and for normal growth.

Example 5

The environment in this example is prepared with maximum concentrations of ingredients, g/l: EN zymes is autolist spleen of cattle - 9,0; microbiological agar - 17,0; potassium phosphate one-deputizing - 1,8; potassium phosphate disubstituted - 4,0; potassium gluconate - 2,8; soluble starch - 2,8; gelatin - 3,0; metainit - 3,0; L-cysteine - 0,8; EDTA iron(III) sodium salt - 0,03; a high quality ink - 10 ml; distilled water to 1 l, pH of 7.1.

Methodology of comparative study of the above indicators of both environments corresponded described (see example 1). Results: growth of up to 20 typical colonies of all tested strains in the test environment with significantly better growth environment comparison (50-60 colonies with reliable statistical difference P - 00,5 Chi-square - 8,0), longer periods of appearance of colonies on the environment of this part for 4-5 day incubation at 35°C. Conclusion: insufficient efficiency of colony growth and turf crops on the environment show that the environment is taken in the present composition does not meet the requirements for diagnostic reference nutrient medium BCYEAά used for culturing and selection Legionella. The test environment in this composition on the above grounds may not be used for detection of antibiotic susceptibility of Legionella cultures and for normal growth.

Example 6

The suitability of the proposed environment in the determination of the antibiotic susceptibility of crops Le is jonell method of disks in comparison with the environment ά

Prepare the environment for the recipe of example 3 and Wednesday ά according to the common recipe. First environment has a dark color, the other black. The volume of media in Petri dishes - 30 ml Prepare odnostoechnye culture of these strains of Legionella, which is seeded on agar plates in both environments 0.1 ml of the suspension of Legionella cells (4×109M. K.), distribute them over the surface and dried agar. Then on agar impose disks with antibiotics, most commonly used to treat legionellosis: rifampicin, ofloxacin, clindamycin, erythromycin, doxycycline, moxifloxacin, azithromycin, levofloxacin, and ciprofloxacin (antibiotic disc 1-1,25 µg). For every Cup of post no more than three disks. Crops incubated for 48 h at 35°C, the first accounting carried out after 24 h by measuring the zone of inhibition of growth of culture and compare their diameters in both environments. On the second day these indicators measure again. The results of comparative tests in determining antibiotikoustoichivosti cultures of Legionella are presented in table 1.

As can be seen from table 1, the zones of inhibition of growth of lawns cultures of Legionella all tested strains around eight discs of antibiotics (rifampicin, ofloxacin, clindamycin, erythromycin, amoxicillin, levofloxacin and ciprofloxacin) on the environment proposed in 2-4 times statisticslecture (with an average Chi-square = 6,3) and higher than similar areas, received on the control environment BCYEAά, explained by the adsorbing action of activated charcoal in the past. A small zone of inhibition of growth of Legionella drive around with doxycycline depends on relatively weak sensitivity of Legionella to the agent, accompanied by complete absence of adsorbing effect. Thus, the proposed environment sensitivity to antibiotics Legionella detected more accurately and completely than in the medium BCYEAά.

Example 7

This example presents the results of a comparative test environment, taken in the optimal composition (as in example 3), and environment BCYEAά to determine the antibiotic susceptibility of Legionella cultures using strips containing a concentration gradient of antibiotic - erythromycin and levofloxacin (produced by Oxoid, F - test). Culture Legionella prepared as described in example 6. Strips nakladyvat planted on the lawn culture at number two on the Cup. Analysis carried out over night incubation at 35°C, the other day the light of the results of repeat. In the presence of culture sensitivity to the subject an antibiotic around the strip formed Racecourse zone of inhibition of growth of a culture of Legionella, the lower edge of the zone of inhibition was consistent with MIC - minimum inhibitory concentration. The results are presented in table the CE 2.

As can be seen from table 2, the zones of inhibition of growth of lawns cultures of Legionella in the environment proposed is approximately 5 times larger than the MICK similar performance to the control environment (average Chi square = 6,3). Therefore, the results of determination of antibiotic susceptibility Legionella using strips are more accurate for the proposed environment.

Example 8

Determining the suitability of the proposed environment to determine the antibiotic susceptibility of Legionella cultures by the method of serial dilutions of antibiotics in comparison with the environment ά

Prepare a Cup with authors and α, as indicated in the previous case, except that on Wednesday injected antibiotic in stepwise increasing concentrations: 0,01, 0,05, 0,1, 0,25, 05, 0,75, 1 mcg/ml are Seeded above culture Legionella on the surface of the agar with antibiotics in a dose - big loop suspension with a concentration of 4×109M. K., forming sowing in the form of a disk with a diameter of 1 see the Crops dried and incubated under the same conditions as in the previous case. The incubation period is 2 days, the account after 24 and 48 hours Results take into account the presence or absence of growth of the culture (see table 3). The parameters are compared for both environments.

As can be seen from table 3, the minimum inhibitory concentration of antibiotics specific for Legionella pneumophila, the proposed environment in 5-10 times less than that in the medium containing activated charcoal.

Therefore, testing of the two environments to determine the antibiotic sensitivity Legionella different methods, namely using discs, strips and serial dilutions, confirmed that the most accurate and reliable working environment B-2.

Therefore, when Troubleshooting a strong adsorbent is activated charcoal, which binds a number of antibiotics, reducing this sensitivity, the new environment provides the ability to accurately determine antibiotikoustoichivosti Legionella pneumophila, not understating the performance inhibition, which is of great importance in clinical practice in the treatment of regionaliza.

Table 1
Strains of Legionella Environment The diameters of zones of inhibition of lawn Legionella drive around with antibiotics (mm):
erythromycin azithromycin clarithromycin doxycin levofloxacin moxifloxacin ofloxacin clindamycin rifampicin
L. pneumophia Philadelphia 1 (virulent), serogroup 1 BCYEAα 30 15 22 8 28 20 30 28 20
B-2 38 20 36 10 0 35 40 40 40
L. pneumophila Philadelphia - 1 (avirulent), serogroup 1 BCYEAα 32 20 23 8 30 20 31 25 30
B-2 40 28 38 9 42 30 44 38 42
L. pneumophilaBloomington (avirulent), 3 serogroup BCYEAα 28 16 20 8 26 21 30 26 19
B-2 36 22 38 10 38 33 41 38 40
L. pneumophila Chicago (avirulent), serogroup 6 BCYEAα 30 20 21 7 22 22 30 26 18
B-2 40 30 32 8 32 36 41 42 38

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Table 2
Strains of Legionella Environment Minimum inhibitory concentration (MIC) of antibiotics was determined using the "strips" (E-test)
Erythromycin (µg) Levofloxacin (µg)
L. pneumophila Philadelphia - 1 (virulent), serogroup 1 BCYEAα 0,5 0,12
B-2 0,1 0,01
L. pneumophila Philadelphia - 1 (avirulent), serogroup 1 BCYEAα 0,5 0,12
B-2 0,1 0,01
L. pneumophila Bloomington (avirulent), 3 serogroup BCYEAα 0,4 0,15
B-2 0,1 0,01
L. pneumophila Chicago (avirulent), serogroup 6 BCYEAα 0,5 0,12
B-2 0,1 0,01

Table 3
Strains of Legionella Environment Minimum inhibitory concentration (MIC) of antibiotics was determined using the method of serial dilutions (g):
erythromycin doxycycline levofloxacin ofloxacin rifampicin
L. pneumophila Philadelphia - 1 (virulent), serogroup 1 BCYEAα 0,5 0,5 0,1 0,25 0,25
B-2 0,1 0,25 0,01 0,01 0,01
L. pneumophila Philadelphia - 1 (avirulent), serogroup 1 BCYEAα 0,5 0,25 0,1 0,25 0,25
B-2 0,12 0,1 0,01 0,01 0,02
L. pneumophila Bloomington (avirulent), 3 serogroup BCYEAα 0,4 0,25 0,1 0,25 0,25
B-2 0,1 0,1 0,01 0,01 0,01
L. pneumophila Chicago (avirulent), serogroup 6 BCYEAα 0,5 0,5 0,1 0,25 0,25
B-2 0,1 0,1 0,01 0,01 0,01

Nutrient medium for determining the antibiotic susceptibility of Legionella pneumophila, including microbiological agar and L-cysteine, characterized in that the composition of the medium was additionally introduced EDTA iron(III) on rieva salt, growth promoters - potassium phosphate one-deputizing and potassium phosphate (disubstituted), and as osmoprotection - metainit and potassium gluconate, at the same time as nutrition in the environment used fermentational spleen of cattle and food gelatin, in the following ratio of components, g/l:

Fermentational spleen of cattle 6-8,0
Agar Microbiology 14,0-16,0
Potassium phosphate one-deputizing 1,5-1,7
Potassium phosphate disubstituted 3,3-3,6
Potassium gluconate 2.4 to 2.6 g
Starch soluble 2,4-2,6
Gelatin 2,4-2,6
Metainit 2,4-2,6
L-cysteine 0,3-0,5
EDTA iron (III) sodium salt 0,026-0,028
Ink high quality 4-6 ml
distillirovanna water at a pH of 7.1 to 1 l

 

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