20600 008041-3 05/01

For in vitro diagnostic use

Identification system for streptococci

API 20 STREP is a standardized method combining 20 biochemical tests that offer widespread capabilities. It enables group or speciesidentification of most streptococci encountered in medical bacteriology. The complete list of those organisms that it is possible toidentify with this system is given in the Identification Table at the end of this package insert.

PRINCIPLEThe API 20 STREP strip consists of 20 microtubes containingdehydrated substrates for the demonstration of enzymatic activityor the fermentation of sugars.The enzymatic tests are inoculated with a dense suspension oforganisms, made from a pure culture, which is used to rehydratethe enzymatic substrates. The metabolic end products producedduring the incubation period are either revealed throughspontaneous colored reactions or by the addition of reagents.The fermentation tests are inoculated with an enriched mediumwhich reconstitutes the sugar substrates. Fermentation ofcarbohydrates is detected by a shift in the pH indicator.The reactions are read according to the Interpretation ofReactions (Table 2) and the identification is obtained by referringto the Analytical Profile Index or using the identification software.

REAGENTSKit contents (25 tests) :

- 25 API 20 STREP strips- 25 incubation boxes- 25 ampules of GP Medium- 25 result sheets- 25 swabs- 1 package insert

Additional products (not included in the kit) :

- Suspension Medium, 2 ml (Prod. No. 70700)- Reagents : Ninhydrin (NIN) (Prod. No. 70490)

Potassium hydroxide (Prod. No. V7053)VP2 or (Prod. No. 70430)

_-naphthol (Prod. No. V7054)ZYME A (Prod. No. 70470)ZYME B (Prod. No. 70480)

- Mineral oil (Prod. No. 70100)- Sterile Pasteur pipettes- McFarland Standard #4 (Prod. No. 70900)- API 20 STREP Analytical Profile Index (Prod. No. 20690) or

identification software (consult bioMérieux)- Ampule rack (Prod. No. 70200)- Columbia blood agar plates- Schaedler broth (optional)

Required laboratory equipment :

- 35-37°C incubator- Refrigerator (2-8°C)- Bunsen burner- Marker pen- Anaerobic jar- Inoculating loop

COMPOSITION OF MEDIA AND REAGENTSSuspensionMedium2 ml

Demineralized water

GP Medium2 ml

Cystine 0.5 gTryptone 20 gSodium chloride 5 gSodium sulfite 0.5 gPhenol red 0.17 gDemineralized water to make 1000 mlpH : 7.8

NIN reagent5 ml

Ninhydrin 7 g2-methoxyethanol 100 ml

TOXICR60 : May impair fertility.R61 : May cause harm to the unborn child.R10 : Flammable.R20/21/22 : Harmful by inhalation, in contact with skinand if swallowed.S53 : Avoid exposure (avoid contact with skin andeyes, vapor inhalation and brutal superheating).S45 : In case of accident or if you feel unwell, seekmedical advice immediately (show the label wherepossible).

Voges-Proskauerreagent:Potassiumhydroxide30 ml

40% aqueous KOH solution 89%in demineralized water 11%

CORROSIVER35 : Causes severe burns.S24/25: Avoid contact with skin and eyes.S26 : In case of contact with eyes, rinse immediatelywith plenty of water and seek medical advice.S36/37/39 : Wear suitable protective clothing, glovesand eye/face protection.S45: Incase of accident or if you feel unwell, seekmedical advice immediately (show the label wherepossible).

VogesProskauerreagent: VP2

5 ml or

alpha-naphthol30 ml

alpha-naphthol 6 gEthyl alcohol 100ml

alpha-naphthol 2.05 gto be diluted with 95% ethyl alcohol 29ml

FLAMMABLE AFTER RECONSTITUTIONR21/22: Harmful in contact with skin and if swallowed.S24/25: Avoid contact with skin and eyes.

ZYME A reagent8 ml

Tris-hydroxymethyl-aminomethane 25 gHydrochloric acid (37 %) 11 mlSodium lauryl sulfate 10 gH2O 100 ml

ZYME B reagent8 ml

Fast Blue BB 0.35 g2-methoxyethanol 100 ml

TOXICR60 : May impair fertility.R61 : May cause harm to the unborn child.R10 : Flammable.R20/21/22 : Harmful by inhalation, in contact with skinand if swallowed.S53 : Avoid exposure - obtain special instructionsbefore use.S45 : In case of accident or if you feel unwell, seekmedical advice immediately (show the label wherepossible).

STORAGE OF THE STRIPS AND MEDIAThe strips and media should be stored at 2-8°C until theexpiration date indicated on the packaging.

STORAGE OF THE REAGENTSThe reagents should be stored in the dark at 2-8°C (exceptPotassium hydroxide and ZYME A which can be stored at 2-30°C) until the expiration date indicated on the packaging. VP2may be kept up to 1 month after the ampules have been openedand the reagent transferred to the dropper-bottle. Afterreconstitution, alpha naphthol should be stored at 2-8°C and maybe kept for up to 90 days, (or until the expiration date if thiscomes first) : record the reconstitution date on the bottle label.The ZYME A, ZYME B and NIN reagents may be kept for up to 1month after the ampules have been opened and the reagentstransferred into the dropper-bottles, (or until the expiration date ifthis comes first) : record the date opened on the bottle label.The NIN and ZYME B reagents are very sensitive tolight : wrap the bottles in aluminum foil and only leave them out ofthe refrigerator while being used. Do not leave them on the benchfor prolonged periods of time.The NIN reagent is very sensitive to traces of water and air :transfer the reagent into the dropper-bottle using a dry pipetteand keep the bottle tightly closed.The ZYME B reagent is normally yellow in color. Dispose of thereagent if any tint of pink (sign of deterioration) is observed.At 2-8°C, the ZYME A reagent may form a precipitate which doesnot affect any of the properties of the reagent and which may beredissolved by gently heating.

USE OF THE REAGENTSAllow reagents to come to room temperature (20-30°C) beforeusing.

1. ZYME A and ZYME B reagents :

• Open the ampule of reagent as indicated in the paragraph"Warnings and Precautions" (ampule with dropper-cap).

• Dispense one drop of reagent.• Carefully close the bottle after use and store it as indicated in

the paragraph "Storage of the reagents".

2. NIN reagent :

• Open the ampule of reagent as indicated in the paragraph"Warnings and Precautions" (ampule with no dropper-cap).

• Take up the contents of the ampule using a completely drypipette and transfer this liquid into the dropper-bottle.

• Fit the dropper to the bottle.• Dispense one drop of reagent.• Carefully close the bottle after use and store it as indicated in

the paragraph "Storage of the reagents".

3. VP2:

• Open the ampule of reagent as indicated in the paragraph Warnings and Precautions" (ampule with dropper cap).

• Dispense one drop of reagent.• Carefully close the bottle after use an store it as indicated in the

paragraph "Storage of the reagents".

4. Alpha-naphthol :

• Reconstitute with 29 ml of 95% ethanol.• Carefully close the bottle.• Shake.• Reagent can be used after active ingredient is completely

disolved.• Dispense one drop of reagent.• Carefully close the bottle after use an store it as indicated in the

paragraph "Storage of the reagents". WARNINGS AND PRECAUTIONS• For in vitro diagnostic use only.• Qualified laboratory personnel should use aseptic technique

and established precautions for infectious agents.• Do not pipette specimens or reagents by mouth.• Do not use reagents past the expiration date.• Do not allow reagents to come into contact with skin, eyes or

clothing.• Do not interchange reagents or consumables between different

lot numbers.• Upon removal from refrigerator, allow reagents to come to

room temperature (20-30°C) before using.• Open ampules carefully as follows :

- Hold the ampule in one hand in a vertical position(white plastic cap uppermost).

- Press the cap down as far as possible. - Cover the flattened part of the cap with the upper

part of the thumb. - Apply thumb pressure in an outward motion to

the flattened part of the cap to snap off the top of the ampule inside the cap.

*For ampule with no dropper-cap : - Carefully remove the cap. *For ampule with dropper-cap : - Turn the ampule upside down and maintain it in

a vertical position. - Squeeze on the cap to transfer all the reagent

into the dropper-bottle.• All inoculated products should be considered infectious and

handled appropriately.• All patient specimens and microbial cultures are potentially

infectious and should be treated with universal precautions(NCCLS M29-A: Protection of Laboratory Workeres fromInstrument Biohazards and Infectious Disease Transmitted byBlood, Body Fluids, and Tissue: Approved Guideline. 1997).

• After completing test, reading and interpretation, all specimens,spills and inoculated products must be autoclaved, incineratedor immersed in a germicide prior to disposal.

• Interpretation of the test results should be made by acompetent microbiologist who should also take intoconsideration the patient history, the source of the specimen,colonial and microscopic morphology and, if necessary, theresults of any other tests performed, particularly theantimicrobial susceptibility patterns.

• Any changes or modifications in the procedure may affect theresults.

INSTRUCTIONS FOR USE Specimens and bacterial cultures should be considered infectiousand handled appropriately by trained and competent technicians. Aseptic technique and usual handling precautions for thebacterial group studied should be observed throughout thisprocedure ; refer to Universal Precautions (NCCLS M29-A:Protection of Laboratory Workers from Instrument Biohazardsand Infectious Diseases Transmitted by Blood, Body Fluids, andTissue : Approved Guideline. 1997). For additional handling precautions, refer to Biosafety inMicrobiological and Biomedical Laboratories, HHS PublicationNo. (CDC) 93-8395, 3rd Edition (May 1993), or to the regulationsof each country.

Selection of colonies

Once the microorganism to be identified has been isolated andverified to be a member of the genus Streptococcus or relatedgenera shown in Table 3 (Gram, catalase test) :• Note the type of hemolysis on the result sheet

(21st test).• Pick a well-isolated colony (Note 1) and suspend it in 0.3 ml of

sterile water. Homogenize well.• Flood a Columbia sheep blood agar plate (Note 2) with this

suspension (or aseptically swab the entire surface of the agar).• Incubate anaerobically for 18-24 hours at 35-37°C.

NOTE 1 : Alpha-hemolytic streptococci and enterococci producesufficiently large colonies after 24 hours of incubation. For otherstreptococci, it is preferable to select a colony after 48 hours ofincubation. For fastidious strains (producing minute colonies after48 hours), the following procedure is recommended : - Culture the colony in 1 ml of Schaedler broth at 35-37°C for 5

hours. - Flood a Columbia sheep blood agar plate with the entire

culture. Remove any excess liquid. - Incubate anaerobically for 18 hours at 35-37°C.

NOTE 2 : In the case of suspected pneumococci, it is advisableto prepare 2 plates in order to obtain sufficient growth.

Preparation of the strip

• Prepare an incubation box (tray and lid) and distribute about 5ml of distilled water or demineralized water [or any waterwithout additives or chemicals which may release gases (e.g.,Cl2, CO2, etc.)] into the honeycombed wells of the tray to createa humid atmosphere.

• Record the strain reference on the elongated flap of the tray.• Remove the strip from its packaging and place it in the tray.

Preparation of the inoculum

• Open an ampule of Suspension Medium (2 ml) as indicated inthe paragraph "Warnings and Precautions" (ampule with nodropper cap) or use any tube containing 2 ml of distilled waterwithout additives.

• Using a swab, harvest all the culture from the previously

prepared subculture plate. Make a dense suspension with aturbidity greater than 4 McFarland.

Inoculation of the strip• In the first half of the strip (tests VP to ADH____ ) distribute the

suspension with a sterile pipette, avoiding the formation ofbubbles (tilt the strip slightly forwards) :

- For the tests VP to LAP : distribute approximately 100 µl into each cupule (3 drops with a Pasteur pipette ).

- For the ADH____ test : fill the tube only.• In the second half of the strip (tests RIB___ to GLYG______) : - Open an ampule of GP Medium as indicated in the

paragraph "Warnings and Precautions" (ampule with no dropper-cap) and transfer the rest of the suspension into it (appr. 0.5 ml). Mix well.

- Distribute this new suspension into the tubes only.

• Fill the cupule of the underlined tests (ADH____ to GLYG______) withmineral oil to form a convex meniscus.

• Place the lid on the tray.• Incubate at 35-37°C for 4 hours to obtain a first reading and for

24 hours to obtain a second reading if this is required.

Reading of the strip

After 4 hours of incubation :• Add the reagents : - VP Test : 1 drop of each of Potassium hydroxide and VP2 or

alpha-naphthol. - HIP Test : 2 drops of NIN reagent. - PYRA, _GAL, _GUR, _GAL, PAL and LAP Tests : 1 drop of

each of ZYME A and ZYME B reagents.• Wait 10 minutes, then read the reactions by referring to the

Interpretation of Reactions Table (Table 2). If necessary,expose the strip to a strong light (10 seconds with a 1000 Wlamp) to decolorize any excess reagents in the tubes PYRA toLAP.

Reincubation is necessary : - if the profile cannot be found in the API 20 STREP Analytical

Profile Index - if the profile is given with the following note :

IDENTIFICATION NOT VALIDBEFORE 24 HOURS OF INCUBATION

After 24 hours, reread the reactions ESC, ADH____ , and RIB___ toGLYG______. Do not reread the enzymatic reactions (HIP, PYRA,_GAL, _GUR, _GAL, PAL, LAP) and VP. Record the reactions onthe result sheet.

Identification Identification can be obtained :

• using the Analytical Profile Index : the pattern of the reactionsobtained must be coded into a numerical profile.

On the result sheet, the tests are separated into groups of 3 and a number 1, 2 or 4 is indicated for each. By adding the numbers corresponding to positive reactions within each group, a 7-digit profile number is obtained.

To obtain information on any profile not listed in the codebook,call the Voice Response System at 800-645-7056.

• using the identification software.

5 240 550 / 5 240 770 Streptococcus mutans

NOTE : The hemolytic reaction constitutes the 21st test ; beta-hemolysis is considered as positive with a numerical value of 4.All other hemolytic reactions are considered as negative with anumerical value of 0. Nevertheless, this test may be ofdiscriminant value for the identification of certain species.

QUALITY CONTROL

The media, strips, and reagents are systematically quality controlled at various stages of their manufacture. For those who wish toperform their own quality control tests with the strip, it is recommended that the following stock cultures be used, to obtain the resultsbelow : Table 1

VP HIP ESC PYRA _GAL _GUR _GAL PAL LAP ADH RIB ARA MAN SOR LAC TRE INU RAF AMD GLYG

1. – – – – – + – + + + + – – + + – – – + +

2. + V + + + V + – V + + + + – + + + + + –

3. + + + V V + – V + + + – + + + + + + – –

4. V V + V V – – – – – – – + – – + – + + –

1. Streptococcus equi ssp zooepidemicus ATCC 7004002. Enterococcus gallinarum ATCC 700425

3. Streptococcus uberis ATCC 7004074. Aerococcus viridans ATCC 700406

ATCC : American Type Culture Collection, 10801 University Boulevard, Manassas, VA 20110-2209, USA.• Inoculum adjusted to between 4.5 and 5.5 McF.• Profiles obtained after : - 4 hours of incubation for tests VP to LAP

- 24 hours of incubation for tests ADH____ to GLYG_____• Strains cultured on Columbia sheep blood agar

DISPOSAL OF USED MATERIALAfter use, all ampules, swabs, pipettes, strips and incubationboxes should be autoclaved, incinerated or immersed in adisinfectant for decontamination prior to disposal.

LIMITATIONSThe API 20 STREP system is intended uniquely for theidentification of those species included in the database (seeIdentification Table (Table 3) at the end of this package insert). Itcannot be used to identify any other microorganisms or toexclude their presence.

RANGE OF EXPECTED VALUESThe API 20 STREP test produces color reactions which makepositive and negative identification possible. Absolute values arenot obtained.

INTERPRETATION OF REACTIONS

Table 2

TESTS SUBSTRATES REACTIONS/ENZYMES RESULTS

NEGATIVE POSITIVE

Potassium hydroxide(1 drop) +VP2or alpha-naphthol (1drop) / wait 10

min

VP Pyruvate Acetoin production Colorless Pink-Red (3)

NIN (2 drops) / wait 10 min

HIP Hippurate Hydrolysis Colorless/Pale blue Dark blue/Violet

4 hrs. 24 hrs. 4 hrs. 24 hrs.

ESC Esculin _-glucosidase ColorlessPale yellow

ColorlessPale yellowLight grey

BlackGrey

Black

ZYME A (1 DROP) + ZYME B (1 DROP) / 10 MIN (PYRA to LAP) (1)if necessary, decolorize with intense light

PYRA Pyrrolidonyl-2-naphthylamide Pyrrolidonyl arylamidase Colorless or very pale orange Orange

_GAL 6-Bromo-2-naphthyl_-D-galactopyranoside _-galactosidase Colorless Violet

_GUR Naphthol AS-BI_-D-glucuronate _-glucuronidase Colorless Blue

_GAL 2-naphthyl- _-D-galactopyranoside _-galactosidase Colorless or very pale violet Violet

PAL 2-naphthyl phosphate Alkaline phosphatase Colorless or very pale violet Violet

LAP L-leucine-2-naphthylamide Leucine arylamidase Colorless Orange

ADH____ Arginine Arginine dihydrolase Yellow Red

4 hrs. 24 hrs. 4 hrs. 24 hrs.

RIB___ Ribose Acidification Red Orange/Red Orange/Yellow Yellow

ARA____ L-Arabinose Acidification Red Orange/Red Orange/Yellow Yellow

MAN____ Mannitol Acidification Red Orange/Red Orange/Yellow Yellow

SOR____ Sorbitol Acidification Red Orange/Red Orange/Yellow Yellow

LAC____ Lactose Acidification Red Orange/Red Orange/Yellow Yellow

TRE____ Trehalose Acidification Red Orange/Red Orange/Yellow Yellow

INU___ Inulin Acidification Red Orange/Red Orange/Yellow Yellow

RAF____ Raffinose Acidification Red Orange/Red Orange/Yellow Yellow

AMD____ Starch (2) Acidification Red Orange/Red Orange/Yellow Yellow

GLYG_____ Glycogen Acidification Red or Orange Bright yellow

(1) During a second reading after 24 hours of incubation, a deposit may be noticed in the tubes where the ZYME A and ZYME B reagents have been added.This phenomenon is normal and should not be taken into consideration.

(2) The acidification of starch is frequently weaker than that of other sugars.

(3) A pale pink color obtained after 10 minutes should be considered negative.

api 20 Strep0 07625 B - 08/97

RECOMMENDED METHODOLOGY

Blood agar

- Cocci - Gram + - Catalase −

Columbia blood agar

24:00 02 37°C

Suspension Medium 2 ml

> 4 McF

GP Medium

VP ADH

ADH

RIB GLYG

RIB GLYG

4:00 37°C

24:00 37°C

api 20 STREP

VP : Potassium hydroxide + VP2 or alpha naphthol HIP : NIN

PYRA LAP : ZYME A + ZYME B

+ - + - + -

IDENTIFICATION TABLE

Table 3% of positive reactions after 4/24 hrs. at 35-37°C

API 20 STREP V6.0 VP HIP ESC PYRA AGAL BGUR BGAL PAL LAP ADH RIB ARA MAN SOR LAC TRE INU RAF AMD GLYG HEM

Aerococcus viridans 1 13 50 96 54 33 16 37 1 5 1 83 33 85 70 83 99 33 41 70 33 1

Aerococcus viridans 2 15 70 50 76 10 20 25 1 5 5 25 1 35 2 70 89 1 5 24 1 5

Aerococcus viridans 3 22 88 99 40 85 48 14 14 1 1 8 2 82 5 91 99 37 99 14 1 1

Alloiococcus otitis 0 25 0 100 0 3 100 1 90 0 0 0 0 0 0 20 0 0 0 0 0

Enterococcus avium 99 60 99 94 15 0 24 1 99 0 99 40 100 95 95 99 1 40 15 0 1

Enterococcus durans 100 43 100 97 32 2 76 0 91 100 99 15 2 0 84 76 0 0 56 0 18

Enterococcus faecalis 99 46 99 97 1 0 21 4 99 94 98 0 98 92 92 100 0 0 96 2 1

Enterococcus faecium 94 43 99 95 42 1 90 3 97 93 85 70 78 18 84 98 26 9 73 3 1

Enterococcus gallinarum 99 99 100 100 95 45 99 0 99 99 99 100 99 1 100 100 99 99 83 20 0

Gardnerella vaginalis 0 95 0 0 0 1 53 0 99 0 46 6 1 0 1 0 0 0 73 53 0

Gemella haemolysans 25 0 0 70 0 0 1 84 40 1 1 0 20 10 5 2 0 0 10 5 1

Gemella morbillorum 3 0 0 35 0 0 10 35 86 4 5 0 1 0 1 11 3 1 16 5 0

Lactococcus lactis ssp cremoris 98 15 41 1 13 0 41 4 89 0 27 0 17 0 96 30 0 20 25 0 0

Lactococcus lactis ssp lactis 90 40 99 35 3 0 35 3 96 95 95 15 45 1 72 87 4 5 90 3 1

Leuconostoc spp 91 1 60 5 55 0 65 2 70 10 37 35 29 4 35 65 0 42 11 0 0

Listeria spp 97 79 98 0 0 0 0 0 85 0 6 0 0 0 49 92 1 1 72 0 26

Abiotrophia adiacens 0 0 10 80 0 25 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0

Abiotrophia defectiva 25 0 15 99 100 0 100 0 92 0 0 0 0 0 99 100 5 93 99 0 0

Streptococcus acidominimus 1 95 4 13 1 66 30 60 96 18 17 0 42 10 70 65 0 0 10 0 0

Streptococcus agalactiae 100 99 1 1 4 79 1 96 99 99 98 0 1 1 50 87 0 1 35 4 75

Streptococcus anginosus 100 0 100 0 44 0 1 99 100 100 0 0 33 0 99 88 0 44 97 0 37

Streptococcus bovis I 97 2 100 2 71 4 14 0 97 0 2 13 86 0 100 90 63 90 100 90 0

Streptococcus bovis II 1 95 4 97 1 86 1 17 0 100 1 0 14 0 0 93 30 61 99 73 65 0

Streptococcus bovis II 2 86 4 100 13 85 88 94 0 100 13 0 1 0 0 99 99 13 72 40 13 0

Streptococcus canis 0 1 25 4 95 1 80 100 100 100 100 0 0 0 99 1 0 1 99 0 100

Streptococcus constellatus 100 1 27 0 0 0 5 99 100 100 0 0 0 0 10 72 0 0 12 0 61

Streptococcus dys.ssp dysgalactiae 0 0 1 1 1 99 0 100 99 100 99 0 1 50 86 100 0 1 99 30 2

Streptococcus dys.ssp equisimilis 0 1 25 1 1 99 1 99 100 97 97 1 1 1 45 99 0 1 98 40 94

Streptococcus equi ssp equi 1 0 1 0 0 100 0 100 100 100 0 0 0 0 0 1 0 0 100 100 100

Streptococcus equi ssp zooepidemicus 0 1 15 0 0 100 1 99 100 99 85 0 0 99 100 0 0 0 99 99 99

Streptococcus equinus 100 0 95 0 28 0 1 1 100 0 0 0 30 0 25 7 25 15 17 10 0

Streptococcus group L 0 75 1 0 0 100 1 100 100 100 100 0 0 0 75 100 0 0 100 98 94

Streptococcus intermedius 100 0 87 0 0 0 44 99 100 100 0 0 0 0 99 99 3 3 99 0 40

Streptococcus mitis 1 1 0 3 1 21 0 25 35 99 19 14 1 0 1 94 7 3 26 67 5 0

Streptococcus mitis 2 0 0 3 0 31 0 35 50 100 99 1 0 1 0 100 1 1 31 84 0 0

Streptococcus mutans 99 0 99 1 64 0 1 1 100 18 0 0 99 90 90 100 81 81 1 0 1

Streptococcus oralis 0 0 1 1 50 0 46 72 100 5 1 0 1 0 99 32 1 72 96 0 0

Streptococcus pneumoniae 0 0 39 60 70 3 79 3 100 57 3 0 0 0 99 98 64 87 84 10 1

Streptococcus porcinus 100 5 99 1 19 99 1 97 97 100 98 0 88 88 83 99 0 0 50 0 100

Streptococcus pyogenes 0 1 5 98 0 15 0 100 100 99 0 0 8 1 99 98 0 1 61 22 98

Streptococcus salivarius ssp salivarius 85 0 98 1 8 0 70 20 100 0 0 0 5 1 86 67 34 88 74 1 1

Streptococcus sanguis 0 1 42 0 63 0 1 5 100 90 0 0 1 48 83 98 33 55 67 0 0

Streptococcus suis I 0 1 82 53 80 94 76 1 100 91 0 0 7 0 94 100 75 0 100 89 0

Streptococcus suis II 0 1 70 41 91 91 52 3 100 95 0 0 3 1 99 98 63 93 99 96 2

Streptococcus uberis 99 98 100 35 10 86 5 30 100 98 99 0 99 98 99 100 89 10 50 20 0

BIBLIOGRAPHY

1. APPELBAUM P.C., CHAURUSHIYA P.S., JACOBS M.R.,DUFFETT A.Evaluation of the Rapid Strep System for SpeciesIdentification of Streptococci.(1984) J. Clin. Microbiol., 19, 588-591.

2. BALL L.C., COLMAN G.A Comparison of Conventional Methods and API Galleriesfor the Identification of Streptococci.(1982) International Meeting on Streptococci andStreptococcal Diseases, LUND SWEDEN, 41-42.

3. BANNISTER M.F., BENSON C.E. and SWEENEY C.R.Rapid Species Identification of Group C StreptococciIsolated from Horses.(1985) J. Clin. Microbiol., 21, 524-526.

4. COLMAN G., BALL L.C.Identification of Streptococci in a Medical Laboratory.(1984) J. Appl. Bact., 57, 1-14.

5. FACKLAM R.R., RHODEN D.L., SMITH P.B.Evaluation of the Rapid Strep System for the Identificationof Clinical Isolates of Streptococcus Species.(1984) J. Clin. Microbiol., 20, 894-898.

6. HUMAN R.P. and TILLOTSON G.S.Identification of Gardnerella vaginalis with the API 20 StrepSystem.(1985) J. Clin. Microbiol., 21, 985-986.

7. KLOOSTERMAN R.E., CULLEN K.D.Comparison of Two Commercial Systems for the RapidIdentification of Streptococci.(1984) ASM ST. LOUIS C198.

8. MacGOWAN A.P., MARSHALL R.J., REEVES D.S.Evaluation of API 20 STREP System for Identifying ListeriaSpecies.(1989) J. Clin. Path., 42, 548-550.

9. RUOFF K.L., KUNZ L.J.Use of the Rapid STREP System for Identification ofViridans Streptococcal Species.(1983) J. Clin. Microbiol., 18, 1138-1140.

10. TILLOTSON G.S.An Evaluation of the API 20 Strep System.(1982) J. Clin. Path., 468-471.

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