Clinical Supplementary Temp. Atmos. Time Cultures details/ media °C read conditions Peritonitis CAPD Neomycin 35-37 40hr Anaerobes (microscopy fastidious suggestive anaerobe agar of mixed with infection) metronidazole 5µg disc Clinical Specimen Optional Incubation Cultures Target organism(s) details/ read Temp. Atmos. Time conditions °C Peritonitis CAPD Staph/strep 35-37 air S. aureus (microscopy selective agar Streptococci suggestive of mixed 35-37 air 16hr Enterobacteriaceae infection) agar Sabouraud agar 35-37 air 40hr Fungi If bottles CAPD Enriched culture 35-37 air continuous Any organism received or eg Blood culture monitoring for bottles (minimum enrichment. subcultured to: 40-48hr) Any suspected Daily infection Terminal subculture if 35-37 5-10% Blood agar appropriate CO2 40hr 35-37 Fastidious anaerobe agar Other organisms for consideration – *incubation may be extended to 5 d if clinically indicated; in such cases plates should be read at and then left in 40hr the incubator/cabinet until day 5. Certain opportunistic pathogens will require extended incubation. 4.6 Identification Refer to individual SMIs for organism identification. 4.6.1 Minimum level of identification in the laboratory Anaerobes level “anaerobes" Lancefield group level genus level "coagulase negative" level All other organisms species level Organisms may be further identified if this is clinically or epidemiologically indicated.
Clinical details/ conditions Supplementary media Cultures read Temp. °C Atmos. Time Peritonitis (microscopy suggestive of mixed infection) CAPD Neomycin fastidious anaerobe agar with metronidazole 5µg disc 35-37 40hr Anaerobes Clinical details/ conditions Specimen Optional Incubation Cultures read Target organism(s) Temp. °C Atmos. Time Peritonitis (microscopy suggestive of mixed infection) CAPD Staph/strep selective agar 35-37 air S. aureus Streptococci agar 35-37 air 16hr Enterobacteriaceae Sabouraud agar 35-37 air 40hr Fungi If bottles received or for enrichment. Any suspected infection CAPD Enriched culture eg Blood culture bottles subcultured to: Blood agar Fastidious anaerobe agar 35-37 35-37 35-37 air 5-10% CO2 continuous monitoring (minimum 40-48hr) Daily Terminal subculture if appropriate 40hr Any organism Other organisms for consideration – *incubation may be extended to 5 d if clinically indicated; in such cases plates should be read at 40hr and then left in the incubator/cabinet until day 5. Certain opportunistic pathogens will require extended incubation. 4.6 Identification Refer to individual SMIs for organism identification. 4.6.1 Minimum level of identification in the laboratory Anaerobes “anaerobes" level Lancefield group level genus level "coagulase negative" level All other organisms species level Organisms may be further identified if this is clinically or epidemiologically indicated.
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