20600

Identification system for streptococci

008041-3 05/01

For in vitro diagnostic use

API 20 STREP is a standardized method combining 20 biochemical tests that offer widespread capabilities. It enables group or species identification of most streptococci encountered in medical bacteriology. The complete list of those organisms that it is possible to identify with this system is given in the Identification Table at the end of this package insert.

PRINCIPLE
The API 20 STREP strip consists of 20 microtubes containing dehydrated substrates for the demonstration of enzymatic activity or the fermentation of sugars. The enzymatic tests are inoculated with a dense suspension of organisms, made from a pure culture, which is used to rehydrate the enzymatic substrates. The metabolic end products produced during the incubation period are either revealed through spontaneous colored reactions or by the addition of reagents. The fermentation tests are inoculated with an enriched medium which reconstitutes the sugar substrates. Fermentation of carbohydrates is detected by a shift in the pH indicator. The reactions are read according to the Interpretation of Reactions (Table 2) and the identification is obtained by referring to the Analytical Profile Index or using the identification software.

COMPOSITION OF MEDIA AND REAGENTS
Suspension Medium 2 ml GP Medium 2 ml Demineralized water

NIN reagent 5 ml

Cystine Tryptone Sodium chloride Sodium sulfite Phenol red Demineralized water pH : 7.8 Ninhydrin 2-methoxyethanol

0.5 g 20 g 5g 0.5 g 0.17 g to make 1000 ml 7g 100 ml

REAGENTS
Kit contents (25 tests) : - 25 API 20 STREP strips - 25 incubation boxes - 25 ampules of GP Medium - 25 result sheets - 25 swabs - 1 package insert Additional products (not included in the kit) : - Suspension Medium, 2 ml (Prod. No. 70700) - Reagents : Ninhydrin (NIN) (Prod. No. 70490) Potassium hydroxide (Prod. No. V7053) VP2 or (Prod. No. 70430) _-naphthol (Prod. No. V7054) ZYME A (Prod. No. 70470) ZYME B (Prod. No. 70480) - Mineral oil (Prod. No. 70100) - Sterile Pasteur pipettes - McFarland Standard #4 (Prod. No. 70900) - API 20 STREP Analytical Profile Index (Prod. No. 20690) or identification software (consult bioMérieux) - Ampule rack (Prod. No. 70200) - Columbia blood agar plates - Schaedler broth (optional) Required laboratory equipment : - 35-37°C incubator - Refrigerator (2-8°C) - Bunsen burner - Marker pen - Anaerobic jar - Inoculating loop
VogesProskauer reagent: Potassium hydroxide 30 ml

TOXIC R60 : May impair fertility. R61 : May cause harm to the unborn child. R10 : Flammable. R20/21/22 : Harmful by inhalation, in contact with skin and if swallowed. S53 : Avoid exposure (avoid contact with skin and eyes, vapor inhalation and brutal superheating). S45 : In case of accident or if you feel unwell, seek medical advice immediately (show the label where possible). 40% aqueous KOH solution 89% in demineralized water 11% CORROSIVE R35 : Causes severe burns. S24/25: Avoid contact with skin and eyes. S26 : In case of contact with eyes, rinse immediately with plenty of water and seek medical advice. S36/37/39 : Wear suitable protective clothing, gloves and eye/face protection. S45: Incase of accident or if you feel unwell, seek medical advice immediately (show the label where possible). alpha-naphthol Ethyl alcohol 6g 100ml

Voges Proskauer reagent: VP2 5 ml or alpha-naphthol 30 ml

alpha-naphthol to be diluted with 95% ethyl alcohol

2.05 g 29ml

ZYME A reagent 8 ml

ZYME B reagent 8 ml

FLAMMABLE AFTER RECONSTITUTION R21/22: Harmful in contact with skin and if swallowed. S24/25: Avoid contact with skin and eyes. Tris-hydroxymethyl-aminomethane 25 g Hydrochloric acid (37 %) 11 ml Sodium lauryl sulfate 10 g H2 O 100 ml Fast Blue BB 0.35 g 2-methoxyethanol 100 ml TOXIC R60 : May impair fertility. R61 : May cause harm to the unborn child. R10 : Flammable. R20/21/22 : Harmful by inhalation, in contact with skin and if swallowed. S53 : Avoid exposure - obtain special instructions before use. S45 : In case of accident or if you feel unwell, seek medical advice immediately (show the label where possible).

STORAGE OF THE STRIPS AND MEDIA
The strips and media should be stored at 2-8°C until the expiration date indicated on the packaging.

4. Alpha-naphthol : • • • • Reconstitute with 29 ml of 95% ethanol. Carefully close the bottle. Shake. Reagent can be used after active ingredient is completely disolved. • Dispense one drop of reagent. • Carefully close the bottle after use an store it as indicated in the paragraph "Storage of the reagents".

STORAGE OF THE REAGENTS
The reagents should be stored in the dark at 2-8°C (except Potassium hydroxide and ZYME A which can be stored at 230°C) until the expiration date indicated on the packaging. VP2 may be kept up to 1 month after the ampules have been opened and the reagent transferred to the dropper-bottle. After reconstitution, alpha naphthol should be stored at 2-8°C and may be kept for up to 90 days, (or until the expiration date if this comes first) : record the reconstitution date on the bottle label. The ZYME A, ZYME B and NIN reagents may be kept for up to 1 month after the ampules have been opened and the reagents transferred into the dropper-bottles, (or until the expiration date if this comes first) : record the date opened on the bottle label. The NIN and ZYME B reagents are very sensitive to light : wrap the bottles in aluminum foil and only leave them out of the refrigerator while being used. Do not leave them on the bench for prolonged periods of time. The NIN reagent is very sensitive to traces of water and air : transfer the reagent into the dropper-bottle using a dry pipette and keep the bottle tightly closed. The ZYME B reagent is normally yellow in color. Dispose of the reagent if any tint of pink (sign of deterioration) is observed. At 2-8°C, the ZYME A reagent may form a precipitate which does not affect any of the properties of the reagent and which may be redissolved by gently heating.

WARNINGS AND PRECAUTIONS
• For in vitro diagnostic use only. • Qualified laboratory personnel should use aseptic technique and established precautions for infectious agents. • Do not pipette specimens or reagents by mouth. • Do not use reagents past the expiration date. • Do not allow reagents to come into contact with skin, eyes or clothing. • Do not interchange reagents or consumables between different lot numbers. • Upon removal from refrigerator, allow reagents to come to room temperature (20-30°C) before using. • Open ampules carefully as follows : - Hold the ampule in one hand in a vertical position (white plastic cap uppermost). - Press the cap down as far as possible. - Cover the flattened part of the cap with the upper part of the thumb. - Apply thumb pressure in an outward motion to the flattened part of the cap to snap off the top of the ampule inside the cap. *For ampule with no dropper-cap : - Carefully remove the cap. *For ampule with dropper-cap : - Turn the ampule upside down and maintain it in a vertical position. - Squeeze on the cap to transfer all the reagent into the dropper-bottle. • All inoculated products should be considered infectious and handled appropriately. • All patient specimens and microbial cultures are potentially infectious and should be treated with universal precautions (NCCLS M29-A: Protection of Laboratory Workeres from Instrument Biohazards and Infectious Disease Transmitted by Blood, Body Fluids, and Tissue: Approved Guideline. 1997). • After completing test, reading and interpretation, all specimens, spills and inoculated products must be autoclaved, incinerated or immersed in a germicide prior to disposal. • Interpretation of the test results should be made by a competent microbiologist who should also take into consideration the patient history, the source of the specimen, colonial and microscopic morphology and, if necessary, the results of any other tests performed, particularly the antimicrobial susceptibility patterns. • Any changes or modifications in the procedure may affect the results.

USE OF THE REAGENTS
Allow reagents to come to room temperature (20-30°C) before using. 1. ZYME A and ZYME B reagents : • Open the ampule of reagent as indicated in the paragraph "Warnings and Precautions" (ampule with dropper-cap). • Dispense one drop of reagent. • Carefully close the bottle after use and store it as indicated in the paragraph "Storage of the reagents". 2. NIN reagent : • Open the ampule of reagent as indicated in the paragraph "Warnings and Precautions" (ampule with no dropper-cap). • Take up the contents of the ampule using a completely dry pipette and transfer this liquid into the dropper-bottle. • Fit the dropper to the bottle. • Dispense one drop of reagent. • Carefully close the bottle after use and store it as indicated in the paragraph "Storage of the reagents". 3. VP2: • Open the ampule of reagent as indicated in the paragraph Warnings and Precautions" (ampule with dropper cap). • Dispense one drop of reagent. • Carefully close the bottle after use an store it as indicated in the paragraph "Storage of the reagents".

INSTRUCTIONS FOR USE
Specimens and bacterial cultures should be considered infectious and handled appropriately by trained and competent technicians. Aseptic technique and usual handling precautions for the bacterial group studied should be observed throughout this procedure ; refer to Universal Precautions (NCCLS M29-A: Protection of Laboratory Workers from Instrument Biohazards and Infectious Diseases Transmitted by Blood, Body Fluids, and Tissue : Approved Guideline. 1997). For additional handling precautions, refer to Biosafety in Microbiological and Biomedical Laboratories, HHS Publication No. (CDC) 93-8395, 3rd Edition (May 1993), or to the regulations of each country. Selection of colonies Once the microorganism to be identified has been isolated and verified to be a member of the genus Streptococcus or related genera shown in Table 3 (Gram, catalase test) : • Note the type of hemolysis on the result sheet (21st test). • Pick a well-isolated colony (Note 1) and suspend it in 0.3 ml of sterile water. Homogenize well. • Flood a Columbia sheep blood agar plate (Note 2) with this suspension (or aseptically swab the entire surface of the agar). • Incubate anaerobically for 18-24 hours at 35-37°C. NOTE 1 : Alpha-hemolytic streptococci and enterococci produce sufficiently large colonies after 24 hours of incubation. For other streptococci, it is preferable to select a colony after 48 hours of incubation. For fastidious strains (producing minute colonies after 48 hours), the following procedure is recommended : - Culture the colony in 1 ml of Schaedler broth at 35-37°C for 5 hours. - Flood a Columbia sheep blood agar plate with the entire culture. Remove any excess liquid. - Incubate anaerobically for 18 hours at 35-37°C. NOTE 2 : In the case of suspected pneumococci, it is advisable to prepare 2 plates in order to obtain sufficient growth. Preparation of the strip • Prepare an incubation box (tray and lid) and distribute about 5 ml of distilled water or demineralized water [or any water without additives or chemicals which may release gases (e.g., Cl2, CO 2, etc.)] into the honeycombed wells of the tray to create a humid atmosphere. • Record the strain reference on the elongated flap of the tray. • Remove the strip from its packaging and place it in the tray. Preparation of the inoculum • Open an ampule of Suspension Medium (2 ml) as indicated in the paragraph "Warnings and Precautions" (ampule with no dropper cap) or use any tube containing 2 ml of distilled water without additives.

• Using a swab, harvest all the culture from the previously prepared subculture plate. Make a dense suspension with a turbidity greater than 4 McFarland. Inoculation of the strip • In the first half of the strip (tests VP to ____ ) distribute the ADH suspension with a sterile pipette, avoiding the formation of bubbles (tilt the strip slightly forwards) : - For the tests VP to LAP : distribute approximately 100 µl into each cupule (3 drops with a Pasteur pipette ). - For the ____ test : fill the tube only. ADH • In the second half of the strip (tests RIB to ______ ) : GLYG ___ - Open an ampule of GP Medium as indicated in the paragraph "Warnings and Precautions" (ampule with no dropper-cap) and transfer the rest of the suspension into it (appr. 0.5 ml). Mix well. - Distribute this new suspension into the tubes only. GLYG • Fill the cupule of the underlined tests (ADH to ______ ) with ____ mineral oil to form a convex meniscus. • Place the lid on the tray. • Incubate at 35-37°C for 4 hours to obtain a first reading and for 24 hours to obtain a second reading if this is required. Reading of the strip After 4 hours of incubation : • Add the reagents : - VP Test : 1 drop of each of Potassium hydroxide and VP2 or alpha-naphthol. - HIP Test : 2 drops of NIN reagent. - PYRA, _GAL, _GUR, _GAL, PAL and LAP Tests : 1 drop of each of ZYME A and ZYME B reagents. • Wait 10 minutes, then read the reactions by referring to the Interpretation of Reactions Table (Table 2). If necessary, expose the strip to a strong light (10 seconds with a 1000 W lamp) to decolorize any excess reagents in the tubes PYRA to LAP. Reincubation is necessary : - if the profile cannot be found in the API 20 STREP Analytical Profile Index - if the profile is given with the following note : IDENTIFICATION NOT VALID BEFORE 24 HOURS OF INCUBATION After 24 hours, reread the reactions ESC, ____ , and RIB to ADH ___ GLYG ______ . Do not reread the enzymatic reactions (HIP, PYRA, _GAL, _GUR, _GAL, PAL, LAP) and VP. Record the reactions on the result sheet.

Identification Identification can be obtained : • using the Analytical Profile Index : the pattern of the reactions obtained must be coded into a numerical profile. On the result sheet, the tests are separated into groups of 3 and a number 1, 2 or 4 is indicated for each. By adding the numbers corresponding to positive reactions within each group, a 7-digit profile number is obtained. To obtain information on any profile not listed in the codebook, call the Voice Response System at 800-645-7056. • using the identification software.

5 240 550 / 5 240 770 Streptococcus mutans

NOTE : The hemolytic reaction constitutes the 21st test ; betahemolysis is considered as positive with a numerical value of 4. All other hemolytic reactions are considered as negative with a numerical value of 0. Nevertheless, this test may be of discriminant value for the identification of certain species.

QUALITY CONTROL
The media, strips, and reagents are systematically quality controlled at various stages of their manufacture. For those who wish to perform their own quality control tests with the strip, it is recommended that the following stock cultures be used, to obtain the results below : Table 1
VP 1. 2. 3. 4. – + + V HIP ESC PYRA _GAL – V + V – + + + – + V V – + V V

_GUR _ GAL
+ V + – – + – –

PAL LAP ADH + – V – + V + – + + + –

RIB ARA MAN SOR LAC TRE INU RAF AMD GLYG + + + – – + – – – + + + + – + – + + + – – + + + – + + – – + + + + + – + + – – – ATCC 700407 ATCC 700406

1. Streptococcus equi ssp zooepidemicus 2. Enterococcus gallinarum

ATCC 700400 ATCC 700425

3. Streptococcus uberis 4. Aerococcus viridans

ATCC : American Type Culture Collection, 10801 University Boulevard, Manassas, VA 20110-2209, USA.
• Inoculum adjusted to between 4.5 and 5.5 McF. • Profiles obtained after : - 4 hours of incubation for tests VP to LAP - 24 hours of incubation for tests ____ to _____ ADH GLYG • Strains cultured on Columbia sheep blood agar

DISPOSAL OF USED MATERIAL
After use, all ampules, swabs, pipettes, strips and incubation boxes should be autoclaved, incinerated or immersed in a disinfectant for decontamination prior to disposal.

LIMITATIONS
The API 20 STREP system is intended uniquely for the identification of those species included in the database (see Identification Table (Table 3) at the end of this package insert). It cannot be used to identify any other microorganisms or to exclude their presence.

RANGE OF EXPECTED VALUES
The API 20 STREP test produces color reactions which make positive and negative identification possible. Absolute values are not obtained.

INTERPRETATION OF REACTIONS Table 2 TESTS SUBSTRATES REACTIONS/ENZYMES NEGATIVE RESULTS POSITIVE

Potassium hydroxide(1 drop) +VP2 or alpha-naphthol (1drop) / wait 10 min VP Pyruvate Acetoin production Colorless NIN (2 drops) / wait 10 min HIP Hippurate Hydrolysis Colorless/Pale blue 4 hrs. ESC Esculin _-glucosidase Colorless Pale yellow 24 hrs. Colorless Pale yellow Light grey 4 hrs. Black Grey Dark blue/Violet 24 hrs. Black Pink-Red (3)

ZYME A (1 DROP) + ZYME B (1 DROP) / 10 MIN (PYRA to LAP) (1) if necessary, decolorize with intense light PYRA _GAL _GUR _GAL PAL LAP ADH ____ Pyrrolidonyl-2-naphthylamide 6-Bromo-2-naphthyl _-D-galactopyranoside Naphthol AS-BI _-D-glucuronate 2-naphthyl- _-Dgalactopyranoside 2-naphthyl phosphate L-leucine-2-naphthylamide Arginine Pyrrolidonyl arylamidase _-galactosidase Colorless or very pale orange Colorless Colorless Colorless or very pale violet Colorless or very pale violet Colorless Yellow 4 hrs. RIB ___ ARA ____ MAN ____ SOR ____ LAC ____ TRE ____ INU ___ RAF ____ AMD ____ GLYG _____ Ribose L-Arabinose Mannitol Sorbitol Lactose Trehalose Inulin Raffinose Starch (2) Glycogen Acidification Acidification Acidification Acidification Acidification Acidification Acidification Acidification Acidification Acidification Red Red Red Red Red Red Red Red Red 24 hrs. Orange/Red Orange/Red Orange/Red Orange/Red Orange/Red Orange/Red Orange/Red Orange/Red Orange/Red Red or Orange 4 hrs. Orange/Yellow Orange/Yellow Orange/Yellow Orange/Yellow Orange/Yellow Orange/Yellow Orange/Yellow Orange/Yellow Orange/Yellow Orange Violet Blue Violet Violet Orange Red 24 hrs. Yellow Yellow Yellow Yellow Yellow Yellow Yellow Yellow Yellow

_-glucuronidase _-galactosidase
Alkaline phosphatase Leucine arylamidase Arginine dihydrolase

Bright yellow

(1) During a second reading after 24 hours of incubation, a deposit may be noticed in the tubes where the ZYME A and ZYME B reagents have been added. This phenomenon is normal and should not be taken into consideration. (2) The acidification of starch is frequently weaker than that of other sugars. (3) A pale pink color obtained after 10 minutes should be considered negative.

api 20 Strep

0
RECOMMENDED METHODOLOGY - Cocci - Gram + - Catalase −

07625 B - 08/97

Blood agar

Columbia blood agar

24:00

02

37°C

>

4 McF

Suspension Medium 2 ml

VP ADH

ADH

GP Medium

RIB

GLYG

RIB

GLYG

4:00

37°C

24:00

37°C

VP HIP api 20 STREP PYRA

: Potassium hydroxide + VP2 or alpha naphthol : NIN LAP : ZYME A + ZYME B

+ - + - + -

IDENTIFICATION TABLE Table 3 % of positive reactions after 4/24 hrs. at 35-37°C API 20 STREP Aerococcus viridans 1 Aerococcus viridans 2 Aerococcus viridans 3 Alloiococcus otitis Enterococcus avium Enterococcus durans Enterococcus faecalis Enterococcus faecium Enterococcus gallinarum Gardnerella vaginalis Gemella haemolysans Gemella morbillorum Lactococcus lactis ssp cremoris Lactococcus lactis ssp lactis Leuconostoc spp Listeria spp Abiotrophia adiacens Abiotrophia defectiva Streptococcus acidominimus Streptococcus agalactiae Streptococcus anginosus Streptococcus bovis I Streptococcus bovis II 1 Streptococcus bovis II 2 Streptococcus canis Streptococcus constellatus Streptococcus dys.ssp dysgalactiae Streptococcus dys.ssp equisimilis Streptococcus equi ssp equi Streptococcus equi ssp zooepidemicus Streptococcus equinus Streptococcus group L Streptococcus intermedius Streptococcus mitis 1 Streptococcus mitis 2 Streptococcus mutans Streptococcus oralis Streptococcus pneumoniae Streptococcus porcinus Streptococcus pyogenes Streptococcus salivarius ssp salivarius Streptococcus sanguis Streptococcus suis I Streptococcus suis II Streptococcus uberis V6.0 VP 13 15 22 0 99 100 99 94 99 0 25 3 98 90 91 97 0 25 1 100 100 97 95 86 0 100 0 0 1 0 100 0 100 1 0 99 0 0 100 0 85 0 0 0 99 HIP ESC PYRA AGAL BGUR 50 70 88 25 60 43 46 43 99 95 0 0 15 40 1 79 0 0 95 99 0 2 4 4 1 1 0 1 0 1 0 75 0 0 0 0 0 0 5 1 0 1 1 1 98 96 50 99 0 99 100 99 99 100 0 0 0 41 99 60 98 10 15 4 1 100 100 97 100 25 27 1 25 1 15 95 1 87 3 3 99 1 39 99 5 98 42 82 70 100 54 76 40 100 94 97 97 95 100 0 70 35 1 35 5 0 80 99 13 1 0 2 1 13 4 0 1 1 0 0 0 0 0 1 0 1 1 60 1 98 1 0 53 41 35 33 10 85 0 15 32 1 42 95 0 0 0 13 3 55 0 0 100 1 4 44 71 86 85 95 0 1 1 0 0 28 0 0 21 31 64 50 70 19 0 8 63 80 91 10 16 20 48 3 0 2 0 1 45 1 0 0 0 0 0 0 25 0 66 79 0 4 1 88 1 0 99 99 100 100 0 100 0 0 0 0 0 3 99 15 0 0 94 91 86 BGAL PAL LAP ADH 37 25 14 100 24 76 21 90 99 53 1 10 41 35 65 0 0 100 30 1 1 14 17 94 80 5 0 1 0 1 1 1 44 25 35 1 46 79 1 0 70 1 76 52 5 1 1 14 1 1 0 4 3 0 0 84 35 4 3 2 0 0 0 60 96 99 0 0 0 100 99 100 99 100 99 1 100 99 35 50 1 72 3 97 100 20 5 1 3 30 5 5 1 90 99 91 99 97 99 99 40 86 89 96 70 85 99 92 96 99 100 97 100 100 100 100 99 100 100 100 100 100 100 99 100 100 100 100 97 100 100 100 100 100 100 1 5 1 0 0 100 94 93 99 0 1 4 0 95 10 0 0 0 18 99 100 0 1 13 100 100 100 97 100 99 0 100 100 19 99 18 5 57 100 99 0 90 91 95 98 RIB ARA MAN 83 25 8 0 99 99 98 85 99 46 1 5 27 95 37 6 0 0 17 98 0 2 0 0 100 0 99 97 0 85 0 100 0 14 1 0 1 3 98 0 0 0 0 0 99 33 1 2 0 40 15 0 70 100 6 0 0 0 15 35 0 0 0 0 0 0 13 14 1 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 85 35 82 0 100 2 98 78 99 1 20 1 17 45 29 0 0 0 42 1 33 86 0 0 0 0 1 1 0 0 30 0 0 0 1 99 1 0 88 8 5 1 7 3 99 SOR 70 2 5 0 95 0 92 18 1 0 10 0 0 1 4 0 0 0 10 1 0 0 0 0 0 0 50 1 0 99 0 0 0 1 0 90 0 0 88 1 1 48 0 1 98 LAC TRE INU RAF AMD GLYG HEM 83 70 91 0 95 84 92 84 100 1 5 1 96 72 35 49 0 99 70 50 99 100 93 99 99 10 86 45 0 100 25 75 99 94 100 90 99 99 83 99 86 83 94 99 99 99 89 99 20 99 76 100 98 100 0 2 11 30 87 65 92 0 100 65 87 88 90 30 99 1 72 100 99 1 0 7 100 99 7 1 100 32 98 99 98 67 98 100 98 100 33 1 37 0 1 0 0 26 99 0 0 3 0 4 0 1 0 5 0 0 0 63 61 13 0 0 0 0 0 0 25 0 3 3 1 81 1 64 0 0 34 33 75 63 89 41 5 99 0 40 0 0 9 99 0 0 1 20 5 42 1 0 93 0 1 44 90 99 72 1 0 1 1 0 0 15 0 3 26 31 81 72 87 0 1 88 55 0 93 10 70 24 14 0 15 56 96 73 83 73 10 16 25 90 11 72 0 99 10 35 97 100 73 40 99 12 99 98 100 99 17 100 99 67 84 1 96 84 50 61 74 67 100 99 50 33 1 1 0 0 0 2 3 20 53 5 5 0 3 0 0 0 0 0 4 0 90 65 13 0 0 30 40 100 99 10 98 0 5 0 0 0 10 0 22 1 0 89 96 20 1 5 1 0 1 18 1 1 0 0 1 0 0 1 0 26 0 0 0 75 37 0 0 0 100 61 2 94 100 99 0 94 40 0 0 1 0 1 100 98 1 0 0 2 0

BIBLIOGRAPHY 1. APPELBAUM P.C., CHAURUSHIYA P.S., JACOBS M.R., DUFFETT A. Evaluation of the Rapid Strep System for Species Identification of Streptococci. (1984) J. Clin. Microbiol., 19, 588-591. 2. BALL L.C., COLMAN G. A Comparison of Conventional Methods and API Galleries for the Identification of Streptococci. (1982) International Meeting on Streptococci and Streptococcal Diseases, LUND SWEDEN, 41-42. 3. BANNISTER M.F., BENSON C.E. and SWEENEY C.R. Rapid Species Identification of Group C Streptococci Isolated from Horses. (1985) J. Clin. Microbiol., 21, 524-526. 4. COLMAN G., BALL L.C. Identification of Streptococci in a Medical Laboratory. (1984) J. Appl. Bact., 57, 1-14. 5. FACKLAM R.R., RHODEN D.L., SMITH P.B. Evaluation of the Rapid Strep System for the Identification of Clinical Isolates of Streptococcus Species. (1984) J. Clin. Microbiol., 20, 894-898. 6. HUMAN R.P. and TILLOTSON G.S. Identification of Gardnerella vaginalis with the API 20 Strep System. (1985) J. Clin. Microbiol., 21, 985-986. 7. KLOOSTERMAN R.E., CULLEN K.D. Comparison of Two Commercial Systems for the Rapid Identification of Streptococci. (1984) ASM ST. LOUIS C198. 8. MacGOWAN A.P., MARSHALL R.J., REEVES D.S. Evaluation of API 20 STREP System for Identifying Listeria Species. (1989) J. Clin. Path., 42, 548-550. 9. RUOFF K.L., KUNZ L.J. Use of the Rapid STREP System for Identification of Viridans Streptococcal Species. (1983) J. Clin. Microbiol., 18, 1138-1140. 10. TILLOTSON G.S. An Evaluation of the API 20 Strep System. (1982) J. Clin. Path., 468-471.

Fabricant / Manufacturer bioMérieux SA

bioMérieux SA
au capital de 77 421 420 F 673 620 399 RCS LYON 69280 Marcy-l’Etoile / France tel. (33) 4 78 87 20 00 / fax (33) 4 78 87 20 90

bioMérieux, Inc.
595 Anglum Road Hazelwood, MO 63042-2320 / USA tel. (1) 314-731-8500 / fax (1) 314-731-8800 Imprimé en / Printed in USA