Four methods for identification of gram-negative nonfermenting rods: organisms more commonly encountered in clinical...

Four commercial kits, Oxi/Ferm (OF), API 20E (AP), Minitek (MT; BBL Microbiology Systems), and Flow N/F (NF), were evaluated, without additional tests, for identification of 258 gram-negative nonfermentative rods. OF and MT were read after 48 h of incubation, and AP and NF were read after both 24 and 48 h of incubation, respectively. Overall, OF correctly identified 51% of strains, with 46% as part (but not first) of a spectrum of identifications (SI), and 3% incorrect species identification. MT yielded 85% correct identification, with 15% SI. Of 126 glucose-positive strains, or those with greater than or equal to 3 positive AP reactions after 24 h, 60% were correctly identified, with 40% SI; incubation for an additional 24 h raised the rate of correct identification to 99%, with 1% SI. A total of 132 strains yield less than 3 positive AP reactions after 24 h and were identified after 48 h only; of these, 82% were correctly identified, with 17% SI and 1% incorrect species identification. NF correctly identified 79% of cultures after 24 h, with 21% SI; corresponding figures after an additional 24 h of incubation were 80% and 20%, respectively. All four commercial methods show promise; OF is easiest to inoculate, but requires extra tests for optimal identification. AP reliably identifies the majority of clinically important nonfermenters, with fairly good species identification of saccharolytic strains after 24 h. MT yields reliable identification of most nonfermenters and has the advantage of flexibility. NF is easy to inoculate, yields satisfactory identification rates, and may be read after 24 h of incubation.