Formula
Proteose Peptone #2, 40.0
g
Sodium Phosphate, 5.0
g
Potassium Phosphate, 1.0
g
Sodium Chloride, 2.0
g
Magnesium Sulfate, 0.1
g
Fructose, 6.0
g
Neutral Red (1% soln), 3.0 ml
Cycloserine, 500.0
mg
Cefoxitin, 15.5
mg
Agar, 15.0
g
Distilled Water, 1000.0
ml
Final pH 7.2 +/- 0.2 at 250C.
Final weight 16.0g +/- 1.6.
Precautions
For IN VITRO DIAGNOSTIC USE only. Approved biohazard precautions and aseptic
techniques should be observed when using this product. This product is for use only by properly-trained
and qualified personnel. Sterilize all
biohazard waste prior to disposal.
Storage and Shelf Life
Storage: Upon receipt, store at 2 – 8oC in original container until used.
Avoid overheating or freezing. Do
not use medium if there are signs of deterioration (shrinking, cracking or
discoloration due to oxidation of media) or contamination. The expiration date applies to the product in
its original packaging and stored as directed.
Do not use product past the expiration date shown on the container.
Shelf
Life: 90 days from date of manufacture.
Procedure
Specimen Collection:
Specimens for anaerobic culture should be protected from air (oxygen)
during collection, transport and processing.
Consult appropriate references for detailed instructions concerning
collection and transport of anaerobes.
Methods for Use:
CCFA should be inoculated directly with clinical material or a broth
that has been previously inoculated from clinical material. Inoculated plates should be streaked to
obtain isolated colonies and immediately placed in an anaerobic atmosphere and
incubated at 35-37oC for 18-48 hours. Quantitation of C. difficile in a specimen may be clinically useful, which can be
achieved by thoroughly mixing a serial 10-fold dilution of the specimen in an
anaerobic environment followed by plating the dilutions onto CCFA media. Detailed instructions for processing
anaerobic cultures can be found in the appropriate references.
Materials Required But Not Provided
Standard
microbiological supplies and equipment such as loops, saline blanks, slides,
staining supplies, microscope, incinerator / autoclave, incubators, anaerobic
chamber, other culture media and serological and biochemical reagents.
Limitations
CCFA will not provide complete information for
identification of bacterial isolates.
Rare strains of C. difficile
may be inhibited. Plates should be
examined no later than after 48 hours of incubation for optimal selectivity as
after 3 – 5 days incubation significant numbers of colonies other than C. difficile may grow. A test for aerotolerance should be used to
confirm that each colony type is an obligate anaerobe. Consult reference materials for additional
information.
Quality Control
CCFA, if used properly, should support good growth
of members of C. difficile. After 24-48 hours, most colonies of C. difficile are large, circular, and
yellow, with yellow coloration extending 2 –3 mm beyond the colony into the
initially orange medium. These colonies
fluoresce golden yellow/chartreuse under long-wavelength UV light. Most other bacteria are inhibited on this
medium. At 48 hours, colonies of most
other organisms (e.g. Lactobacilli and
yeast), which may grow, are very small (pinpoint to 0.5 mm in diameter) and do
not fluoresce golden-yellow.
The following organisms are routinely used for
quality control performance testing at Anaerobe Systems.
|
Organism Tested
|
ATCC #
|
Results
|
Time (Hours)
|
Special Reaction
|
|
Bacteroides fragilis
|
25285
|
No Growth
|
|
|
|
Prevotella melaninogenica
|
25845
|
No Growth
|
|
|
|
Fusobacterium necrophorum
|
25286
|
No Growth
|
|
|
|
Fusobacterium nucleatum
|
25586
|
No Growth
|
|
|
|
Clostridium perfringens
|
13124
|
No Growth
|
|
|
|
Peptostreptococcus anaerobius
|
27337
|
No Growth
|
|
|
|
Staphylococcus
aureus or Enterococcus faecalis
|
25923 29212
|
No Growth
|
|
|
|
Escherichia coli
|
25922
|
No Growth
|
|
|
|
Clostridium
difficile
|
9689
|
Growth
|
24 hours
|
Yellow coloration
|
User
Quality Control: The final determination to the extent and quantity of user
laboratory quality control must be determined by the end user.
If
sterility testing is to be performed on this product, the appropriate
percentage of the original shipment amount should be incubated anaerobically
and aerobically for 48 – 96 hours.
If
the nutritive/inhibitory capacity of this medium is to be tested for
performance, it is recommended that the following ATCC organisms be evaluated
for growth/inhibition.
|
Organism
|
Expected Growth
|
Special Reaction
|
|
B. fragilis
|
Inhibited
|
|
|
E. coli
|
Inhibited
|
|
|
S. aureus
|
Inhibited
|
|
|
C. difficile
|
24 hours
|
Yellow coloration, chartreuse fluorescence
|
Physical Appearance: CCFA should
appear translucent pink/orange in color.
References
1.
Dowell, V. R., Jr. and T. M. Hawkins.
1974. Laboratory Methods in Anaerobic Bacteriology. CDC
Laboratory Manual. USDHEW C. D. C.
Atlanta, GA 30333.
2.
Dowell, V. R., Jr. and G. L. Lombard.
1977. Presumptive Identification of Anaerobic Non-sporeforming Gram-negative Bacilli. USDHEW,
CDC. Atlanta, GA 30333.
3.
Dowell, V. R., Jr., G. L. Lombard, F. S. Thompson and A. Y. Armfield. 1977. Media for the Isolation, Characterization,
and Identification of Obligately Anaerobic Bacteria. USDHEW, CDC, Atlanta, GA 30333.
4.
Holdeman, L. V., F. P. Cato and W. E. C. Moore. 1977. Anaerobe Laboratory Manual. Virginia Polytechnic Institute and State University. Blacksburg,
VA 24061.
5.
Jousimies-Somer, H. R., P. Summanen, D. M. Citron, E. J. Baron, H. M.
Wexler and S. M. Finegold. 2002. Wadsworth – KTL Anaerobic Bacteriology Manual. Star Publishing Co., Belmont, CA 94002.
6.
NCCLS. Quality Control for Commercially Prepared Microbiological Culture
Media; Approved Standard- Third Edition. (2004).
NCCLS document M22-A3. NCCLS, 940 West Valley Road, Suite 1400, Wayne, PA 19087-1898.
7.
George, W. L., V.L. Sutter, D. Citron, S. Finegold. 1979. Selective
and Differential Medium for Isolation of Clostridium
difficile. Journal of Clinical Microbiology.
9:214-219.