Conventional approaches to microbiological examination of specimens require that they be cultured to assess the total numbers of specific groups of microorganisms or to determine the presence or absence of particular named species.
CULTURE TECHNIQUES - TYPES
The simplest way in
which to enumerate the microorganisms that contaminate an object or liquid
sample is to dilute that sample to varying degrees and inoculate the surface of
a pre-dried nutrient agar with known volumes of those dilutions (see Chapter
2). Individual viable bacteria that are able to grow on the nutrients provided
and under the conditions of incubation will produce visible colonies that can
be counted and the numbers related back to the original sample. Such counting
procedures are often lengthy and tedious; the number of colonies formed might
not relate to the viable number of cells, as clumps of cells will only produce
a single colony and they will only detect a particular subset of the viable
bacteria present in the sample that can grow under the chosen conditions.
Accordingly a variety of different media and cultural conditions are deployed
to enumerate different categories of organism.
A number of techniques
are currently being developed in order speed up the enumeration process,
although some of these rapid enumeration techniques indirectly measure the most
probable number of viable cells.
A) Enumeration media
Enumeration media will
only ever culture a subset of cells towards which the medium and incubation
conditions are directed. Thus, simple salts media with relatively simple sugars
as carbon sources and trace levels of amino acids are often used to enumerate bacteria
associated with water (e.g. R2A medium). Such plates may be incubated under
aerobic or anaerobic conditions at a range of temperatures. Different
temperatures will select for different subsets of cells, therefore any
description of a viable bacterial count must specify the incubation condi tions.
In medical microbiology temperatures akin to the human body are often deployed
because only those bacteria able to grow at such temperatures are likely to
cause infection. However, psychrophilic Gram-negative bacteria (growing in
water at 10 °C) can be a major source of bacterial pyrogen, so a variety of
incubation temperatures are often used in monitoring pharmaceutical waters and
products. Highly nutritious media, e.g. blood agar, are also used as enumeration
media. This is particularly the case when looking for microorganisms such as
staphylococci that are usually found in association with animals and humans.
Such agar plates may be deliberately exposed to air (settle plates) and the
number of colonies formed related to the bacteria content of a room. In the
pharmaceutical industry microbiological monitoring will generally report the
total aerobic count and, less commonly, the total anaerobic counts obtained on
a moderately rich medium such as tryptone soya agar. Sometimes inhibitors of
bacterial growth (e.g. Rose Bengal) can be added to a medium in order to select
for moulds.
B) Rapid enumeration techniques
The detection and
quantification of components of bacterial cells is considerably faster than those
approaches requiring the growth of colonies, and estimates of total viable cell
number can thereby be obtained within minutes rather than hours and days.
Some of the rapid
methods that have been used for bacteria and other microorganisms, e.g. bio-luminescence,
epifluorescence and impedance techniques, have been described in Chapter 2, but
there are other rapid methods that have found more limited application; these will
be considered here. In the examination of pharmaceutical waters and aqueous
pharmaceutical products electronic particle counters, e.g. Coulter counters,
can be used to determine bacterial concentration, although these instruments do
not discriminate between living and dead cells. Similar counters are available
that are able to analyse particles found in air. Other rapid techniques aim to
detect microbial growth rather than to visualize individual cells and colonies.
As bacteria grow in liquid culture they not only alter the conductivity of the
culture (see Chapter 2), they also generate small quantities of heat. The time
taken to detect this heat can be directly related to the numbers of viable
cells present by means of micro-calorimeters. Once again this is a considerable
improvement over conventional culture, but unlike particle counting and
bio-luminescence can only detect those organisms that are able to grow in the
chosen medium.
None of the rapid
techniques are able to isolate individual organisms. They do not therefore aid
in the characterization or identification of the contaminants.
Enrichment cultures are
intended to increase the dominance of a numerically minor component of a mixed
culture such that it can be readily detected on an agar plate. Enrichment media
are always liquid and are intended to provide conditions that are favourable
for the growth of the desired organism and un-favourable for the growth of other
likely isolates. This can be achieved either through manipulation of the pH and
tonicity of the medium or by the inclusion of chemicals that inhibit the growth
of unwanted species. Thus, Mac-Conkey broth contains bile salts that will
inhibit the growth of non-enteric bacteria and may be used to enrich for Entero-bacteriaceae.
Several serial passages through enrichment broths may be made, and after enrichment
it is not possible to relate the numbers of organisms detected back to that in
the original sample.
Selective media are solidified
enrichment broths, so again they are intended to suppress the growth of
particular groups of bacteria and to allow the growth of others. The methods of
creating this situation are the same as for enrichment broths. Thus mannitol
salts agar will favour the growth of micrococci and staphylococci, and cetrimide
agar will favour the growth of pseudomonads. The use of selective media is an
adjunct to characterizing the nature of contaminants. Counts of colonies
obtained on selective solid media are often documented as presumptive counts,
so for example, colonies formed on a MacConkey agar (containing bile salts)
might be cited as a presumptive coliform count.
Identification Media (Diagnostic)
Identification media
contain nutrients and reagents that indicate, usually through some form of
colour formation, the presence of particular organisms. This enables them to be
easily detected against a background of other species. In this fashion
inclusion of lactose sugar and a pH indicator into MacConkey agar facilitates
the identification of colonies of bacteria that can ferment lactose.
Fermentation leads to a reduction in pH within these colonies and can be
detected by an acid shift in the pH indicator, usually to red. Lactose-fermenting
coliforms (Escherichia spp., Klebsiella spp.) can therefore be easily
distinguished from non-fermentative coliforms (Salmonella spp., Shigella
spp.). Similarly, the inclusion of egg-yolk lecithin into an agar gives it a
cloudy appearance that clears around colonies of organisms that produce
lecithinase (a virulence factor in staphylococci). While there are numerous
types of selective and diagnostic media available, they can only be used as a
guide to identification, but microscopy and biochemical or genetic
characterization are much more definitive.
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