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Cystine lactose electrolyte deficient agar

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Cystine lactose electrolyte deficient (CLED) agar is a microbiological growth medium used for the isolation and differentiation of urinary tract pathogens. It contains cystine and lactose as the main components, along with electrolytes and other nutrients required for the growth of a variety of bacteria.

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3 protocols using cystine lactose electrolyte deficient agar

1

Comprehensive Microbial Identification and Susceptibility Testing

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Stool samples were routinely cultured on MacConkey agar, xylose lysine deoxycholate agar, and Hektoen agar (Oxoid Ltd, Basingstoke, UK). Stool samples were also inoculated into selenite F broth (Oxoid Ltd, Basingstoke, UK). Blood samples were collected in blood culture bottles and incubated in the BD BACTEC™ blood culture system (Becton, Dickinson and Company, Franklin Lakes, USA). A blood culture sample flagged as positive by the system was inoculated on blood agar, chocolate agar, and MacConkey agar. Identification of microbes from urine samples was performed by plating the sample onto MacConkey agar and cystine lactose electrolyte deficient (CLED) agar (Oxoid Ltd, Basingstoke, UK). Samples, other than stool or blood, e.g. urine, abdominal abscess, and surgical wound swabs, were cultivated as per standard operating procedures followed at the microbiology laboratory at KFHU.
Identification and antimicrobial susceptibility testing of all bacterial isolates was performed by the Vitek2 automated card system (bioMérieux Vitek Inc., Hazelwood, MO, USA). When required, an antimicrobial susceptibility test was performed manually using the disc diffusion method following the Clinical and Laboratory Standards Institute guidelines.20
Salmonella serogrouping was performed using the BD Salmonella antisera (Becton, Dickinson and Company, Franklin Lakes, USA).
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2

Urine Culture Isolation and Identification

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Clean catch mid-stream urine samples were collected from all participants using a wide-mouthed sterile-capped container. The specimen was promptly transported to the microbiology laboratory and cultured within one hour of collection. We used a 0.001 ml calibrated wire loop to inoculate samples onto Cystine Lactose Electrolyte Deficient (CLED) agar, blood agar, and chocolate agar (plates (Oxoid Ltd., Hampshire, United Kingdom) and incubate at 37°C for 24–48 hours. Colony counts yielding bacterial growth of 105/ml of urine were regarded as significant for bacteriuria. Colony characteristics, Gram reaction, and biochemical reactions were used to identify bacterial isolates [29 (link), 30 ]. For the identification of Gram-negative bacteria, oxidase test, lactose fermentation, and hydrogen sulfur (H2S) production in Kligler's iron agar (KIA) test, urease test, citrate test, and indole test were used. Gram positives were also identified using a type of haemolysis, a catalase test, and a coagulase test. Isolated bacteria were later confirmed using API 20E and API 20NE (bioMerieux) for Gram-negative bacteria and API-staph (bioMerieux) and API- Strep (bioMerieux) for Staphylococcus and Streptococcus species, respectively.
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3

Screening Klebsiella pneumoniae Isolates from Oman

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This study was commenced after obtaining approval by the Medical Ethics Research committee (MREC#1896), College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman. Initially, we screened 129 K. pneumoniae clinical isolates for K1, K2, K20, K54, and K57 from various samples (urine, wound, tracheal aspirate, blood, sputum) from patients from Central Public Health Laboratories (CPHL) (Supplementary Figures S1 and S2) representing various areas from Oman collected between 2015 and 2020. Another 30 isolates were screened from Sultan Qaboos University Hospital (SQUH), Muscat, Oman, collected between 2019 and 2021 (Supplementary Table S1). PCR preliminary data are presented in Supplementary Tables S5 and S6, including PCR cycling conditions and primers. Colonies were collected from purity plates of Cystine Lactose Electrolyte-Deficient (CLED) agar (Oxoid, Basingstoke Hampshire, UK). These colonies were used to make frozen stock in beads-containing cryotubes and processed according to the manufacturer’s instructions (Mast Diagnostics, Derby, UK). The samples were frozen at −80 °C for future use.
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