Provisional identification of Haemophilus influenzae from sputum cultures within 1 h by rapid enzyme tests

Possible Haemophilus influenzae colonies in cultures of sputum samples are currently identified by tests for dependence on X and V factors. This method requires further overnight culture and may give a relatively high number of false negative results. Identification of suspected H. influenzae colonies by a 5-min test for production of indole and beta-galactosidase followed by a 1-h porphyrin test was compared with tests for dependence on X and V factors. A commercially produced form of the rapid tests (Haemstrip, Lab M, Bury, Lancs) was used to test 252 potential haemophilus colonies from cultures of sputum samples on heated blood agar. Colonies that were beta-galactosidase-positive after 5 min were considered to be non-H. influenzae and those that were beta-galactosidase-negative but indole-positive were considered to be H. influenzae. At this stage the test had a sensitivity of 99.4% and a specificity of 90.9%. After 1 h, only colonies that were beta-galactosidase- and porphyrin-negative were considered to be H. influenzae, the sensitivity was then 99.5% and the specificity 100%. Similar results were found with colonies from sputum cultures on selective heated blood agar containing bacitracin. The X and V dependence and Haemstrip results were in 97.6% agreement in a double blind test. Of 100 non-haemophilus colonies tested by Haemstrip, two pseudomonads could have been identified as H. influenzae by this method. The high positive predictive value of Haemstrip results depends partly on the initial recognition of potential haemophilus colonies.