A modified oxidase test (Remel, Lenexa, Kans.) and susceptibility to furazolidone and lysostaphin (Remel) were evaluated in conjunction with the Staph-Ident strip (Analytab Products, Plainview, N.Y.) to accurately differentiate between staphylococci and micrococci. A total of 414 clinical isolates of catalasepositive, gram-positive cocci were each tested with the Staph-Ident strip and by glucose fermentatior, acid production from glycerol, susceptibility to furazolidone and lysostaphin, and the oxidase test. Based on the reference methods of glucose fermentation and acid production from glycerol, 396 (95.6%) of the organisms were classified as Staphylococcus species and 18 (4.4%) were classified as Micrococcus species. Of the staphylococci, 99% were oxidase negative and susceptible to furazolidone; 82% were susceptible to lysostaphin. All of the micrococci were oxidase-positive and resistant to furazolidone and lysostaphin. Of the staphylococci, 99% were identified to species by the Staph-Ident strip. However, six (33%) of the micrococci were incorrectly identified as Staphylococcus species (three each of Staphylococcus hominis and Staphylococcus saprophyticus). Because of the demonstrated sensitivity and specificity of the oxidase and furazolidone susceptibility tests, it is suggested that either of these methods be used in the clinical laboratory to accurately differentiate between staphylococci and micrococci. It is also suggested that when working with the Staph-Ident strip, additional testing such as furazolidone susceptibility or oxidase activity should be performed to provide increased accuracy in the differentiation and characterization of members of the family Micrococcaceae.

A latex agglutination test (SeroSTAT Staph; Scott Laboratories, Fiskeville, R.I.) and two hemagglutination tests (Staphyloslide; BBL Microbiology Systems, Cockeysville, Md.; and Hemastaph; Remel, Lenexa, Kans.) were compared with the slide coagulase (SC) and tube coagulase (TC) tests at room temperature (22 to 25°C) and at 37°C for the rapid identification of Staphylococcus aureus. A total of 380 clinical strains of staphylococci were tested. The TC test performed at room temperature yielded the largest number of TC-positive results (n = 239), and based on this observation 239 organisms were classified as S. aureus and 141 were classified as non-S. aureus. The SC, TC (37°C), SeroSTAT Staph, Staphyloslide, and Hemastaph tests correctly identified 210 (87.9%), 221 (92.5%), 238 (99.6%), 239 (100%), and 236 (98.7%) of the S. aureus isolates, respectively. Of the S. aureus isolates that were TC positive at room temperature 68% required 24 h of incubation before coagulase production was detected. There was one false-negative SeroSTAT Staph result and one false-negative Hemastaph result. The Staphyloslide test yielded two noninterpretable results (both organisms were later confirmed as non-S. aureus), whereas there were six noninterpretable results recorded with the Hemastaph test (four organisms were classified as non-S. aureus, and two were classified as S. aureus). The SeroSTAT Staph, Staphyloslide, and Hemastaph tests were all more sensitive than the conventional SC and TC (37°C) tests and were considerably more rapid than the TC test at either temperature.

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Bacitracin susceptibility was evaluated as a laboratory method to differentiate staphylococci from micrococci. A total of 317 staphylococcal isolates and 108 micrococcal isolates were each tested for susceptibility to bacitracin by a disk-diffusion method using disks of three different potencies (0.04, 2.0, and 10.0 U) and a broth dilution method to obtain MICs. When a growth inhibition zone diameter breakpoint of >10 mm was used to establish susceptibility with a 0.04-U disk, all micrococci were bacitracin susceptible and 94.6% of the staphylococci were resistant. Testing with disks of higher potency did not improve the specificity of the disk-diffusion method.