Clinical details/ Specimen Supplementary Incubation Target media read organism(s) conditions Temp. °C Atmos. Time Tissue Selective 35-37 Anaerobic 5d 40hr and Anaerobes If microscopy anaerobic agar at 5d Biopsy suggestive of with infection metronidazole disc 5μg Tissue Blood agar 35-37 Anaerobic 10d 40hr, at Actinomyces supplemented 7d and species Biopsy with 10d Actinomycosis metronidazole and nalidixic acid Tissue Sabouraud agar 35-37 Air 14d daily# Yeasts or Biopsy and Moulds suspected fungal infection 25-30 Mycetoma Tissue 35-37 Air up to every Aerobic slope / 28d days Actinomycetes Biopsy Blood agar species Nocardiosis Tissue agar 35-37 Air Up to 3d and Nocardia 7d 7d species Biopsy Suspected Tissue BMPA or 35-37 Up to 3d, 7d Legionella Legionellosis BCYEA or Atmos 10d and 10d species Biopsy alternative Legionella agar Optional When clinical Tissue Staphylococci/ 35-37 Air daily S. aureus details or when Streptococci Biopsy Streptococci microscopy selective agar suggestive of or infection Manitol Salt or Agar dependent on local policy organisms for consideration Fungi (), H. pylori ()), Listeria species, Mycobacterium species () and parasites (). – #Agents of exotic imported mycoses eg Histoplasma capsulatum may take up to 8 weeks to grow; adequate humidification of incubators will be necessary31,32. 4.6 Identification Refer to individual SMIs for organism identification. 4.6.1 Minimum level of identification in the laboratory Actinomycetes genus level Anaerobes "anaerobes"
Clinical details/ conditions Specimen Supplementary media Incubation read Target organism(s) Temp. °C Atmos. Time If microscopy suggestive of infection Tissue Biopsy Selective anaerobic agar with metronidazole disc 5μg 35-37 Anaerobic 5d 40hr and at 5d Anaerobes Actinomycosis Tissue Biopsy Blood agar supplemented with metronidazole and nalidixic acid 35-37 Anaerobic 10d 40hr, at 7d and 10d Actinomyces species or suspected fungal infection Tissue Biopsy Sabouraud agar 35-37 and 25-30 Air 14d daily# Yeasts Moulds Mycetoma Tissue Biopsy slope / Blood agar 35-37 Air up to 28d every days Aerobic Actinomycetes species Nocardiosis Tissue Biopsy agar 35-37 Air Up to 7d 3d and 7d Nocardia species Suspected Legionellosis Tissue Biopsy BMPA or BCYEA or alternative Legionella agar 35-37 Atmos Up to 10d 3d, 7d and 10d Legionella species Optional When clinical details or when microscopy suggestive of infection or dependent on local policy Tissue Biopsy Staphylococci/ Streptococci selective agar or Manitol Salt Agar 35-37 Air daily S. aureus Streptococci organisms for consideration – Fungi (), H. pylori ()), Listeria species, Mycobacterium species () and parasites (). #Agents of exotic imported mycoses eg Histoplasma capsulatum may take up to 8 weeks to grow; adequate humidification of incubators will be necessary31,32. 4.6 Identification Refer to individual SMIs for organism identification. 4.6.1 Minimum level of identification in the laboratory Actinomycetes genus level Anaerobes "anaerobes"
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