Persaud C A, Eykyn S J
Microbiology Department, St Thomas's Hospital, London.
J Clin Pathol. 1994 Sep;47(9):790-2. doi: 10.1136/jcp.47.9.790.
To assess the best medium for primary isolation of enteric pathogens; to determine the need for a second primary culture medium; and to gather information on stool culture media used in 20 other randomly selected laboratories.
Specimens were cultured on desoxycholate citrate agar (DCA), Hektoen enteric agar (Hektoen), and xylose lysine deoxycholate agar (XLD). Non-lactose fermenters were screened with Rapidec Z (bio-Mérieux) and identified with API 10S (bio-Mérieux) where appropriate. Shigellas were identified with API 20E (bio-Mérieux) and serology, and salmonellas biochemically and by serology. A telephone survey was carried out to enquire into different culture practices and whether they had been evaluated for cost effectiveness.
The isolation rate of enteric pathogens on primary stool culture media was 97% on DCA, 88% on XLD, and 76% on Hektoen. Seventeen of 18 shigellas grew on DCA, 13 of 18 on XLD, and 14 of 18 on Hektoen. DCA missed one Salmonella, XLD three, and Hektoen 13. XLD and Hektoen both missed Yersinia enterocolitica. The telephone survey revealed a diverse range of both primary and subculture plates. There was little evidence of evaluation of stool media, but firm personal convictions concerning the advantages and disadvantages of each type of medium at each stage of culture.
DCA performed best and was the most cost effective of the three media. Neither XLD nor Hektoen were satisfactory as primary culture media because they grew fewer pathogens than DCA.
评估用于肠道病原体初次分离的最佳培养基；确定是否需要第二种初次培养基；收集其他20个随机选择的实验室使用的粪便培养基的相关信息。
将标本接种于去氧胆酸盐柠檬酸盐琼脂（DCA）、赫氏肠道琼脂（Hektoen）和木糖赖氨酸去氧胆酸盐琼脂（XLD）上培养。对非乳糖发酵菌用Rapidec Z（生物梅里埃公司）进行筛选，并在适当情况下用API 10S（生物梅里埃公司）进行鉴定。志贺菌用API 20E（生物梅里埃公司）和血清学方法鉴定，沙门菌用生化方法和血清学方法鉴定。进行电话调查，询问不同的培养方法以及这些方法是否经过成本效益评估。
粪便初次培养基上肠道病原体的分离率在DCA上为97%，在XLD上为88%，在Hektoen上为76%。18株志贺菌中有17株在DCA上生长，18株中有13株在XLD上生长，18株中有14株在Hektoen上生长。DCA漏检1株沙门菌，XLD漏检3株，Hektoen漏检13株。XLD和Hektoen均未检出小肠结肠炎耶尔森菌。电话调查显示，初次培养和继代培养平板种类繁多。几乎没有证据表明对粪便培养基进行过评估，但在培养的每个阶段，对于每种培养基的优缺点都有坚定的个人看法。
DCA表现最佳，是三种培养基中最具成本效益的。XLD和Hektoen作为初次培养基都不令人满意，因为它们培养出的病原体比DCA少。
