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The protocol for the measurement of growth inhibition at tested concentration on a selection of human pathogens.
Materials
**Table 1: Equipment and consumables**
A
B
Equipment
Vendor, product number
Incubator 37 °C
Panasonic Healthcare
Shaking incubator, 37 °C
Heidolph Instruments GmbH
Victor Multilabel Counter
PerkinElmer
**Table 2: growth media and antibiotic**
A
B
Growth media/chemicals
Vendor, product number
MilliQ H2O
Merck Millipore
Mueller-Hinton (MH) broth
Difco, 275730 (21g/L)
Brain Heart Infusion (BHI)
Sigma Aldrich, 53286 (37g/L)
Blood agar plates
SUMP Media, UNN
Gentamicin
Merck Biochrom GmbH, A2712
**Table 3: pathogens, recommended growth media and bacterial density**
A
B
C
Bacterial strain
Vendor, product number
Recommended growth media
Enterococcus faecalis
LGC Standards, ATCC 29212
BHI
Escherichia coli
LGC Standards, ATCC 25922
MH
Pseudomonas aeruginosa
LGC Standards, ATCC 27853
MH
Staphylococcus aureus
LGC Standards, ATCC 25923
MH
Streptococcus agalactiae
LGC Standards, ATCC 12386
BHI
**Additional Materials**:
- Autoclave 5 Erlenmeyer flasks, 100 mL
Safety warnings
The final DMSO concentration in the microtiter plate should not exceed 0.25%.
Method
ASSAY PREPARATIONS
Blood agar plates.
Autoclave MQ-H2O
Autoclave 5 Erlenmeyer flasks, 100 mL.
If needed, prepare and autoclave MH-broth and BHI according to pack instructions.
Transferring pathogens from biofreezer stock to blood agar plates
Streak pathogens from biofreezer on blood agar plates. Keep pathogens on ice during the streaking procedure. Transfer the stock vials back to the biofreezer.
Incubate blood agar plates over night at 37 °C
Transfer blood agar plates to the fridge. These plates can be kept there and used for 2 weeks, before a scoop of bacterial colonies are transferred to a new plate and incubated as in step 1 and 2.
After a total of 4 weeks storage of pathogens on blood agar plates, new stock is streaked out on fresh plates from biofreezer stock.
RUNNING THE ASSAY
Day 1
Transfer a scoop of pathogens from blood agar plate to 8 mL growth media, according to table 3.
Incubate cultures at 37 °C for approximately 20 hours. (**No shaking**)
Day 2
Preparation of stock solution of samples for testing
Prepare working stocks that are twice the final test concentration_. The final DMSO concentration in the samples should not exceed 0.25%.
Transfer 50 µL of sample in duplicate to a microtiter plate according to Figure 1. Transfer 50 µL ddH2O to column 1 and 12. Transfer 50 µL growth medium to column 1.
Preparation of media, equipment and gentamycin control
For each pathogen, prepare the following equipment:
25 mL growth media in 100 mL autoclaved Erlenmeyer flask
9.9 mL growth media in 14 mL Falcon tube
36 mL growth media in 50 mL Falcon tube
Dilution of overnight cultures
Transfer 2 mL overnight culture of each pathogen to separate Erlenmeyer flasks containing 25 mL growth media, according to table 3.
Incubate the diluted pathogens for 1.5 h (E. faecalis, E. coli, S. agalactiae) or 2.5 h (P. aeruginosa, S. aureus) at 37 °C, 100 rpm.
Measure the OD600 of 5 bacterial cultures by 96-well microtiter plate, adjust the bacterial OD600 to E. faecalis is 0.125; to E. coli is 0.08; to P. aeruginosa is 0.075; to S. aureus is 0.08; to S. agalactiae is 0.08.
Transfer 100 µL of the bacterial suspension to 9.9 mL growth medium (dilution factor 1:100).
Transfer 4 mL bacterial suspension from step 3 to 36 mL growth medium (dilution factor 1:10).
Transfer 50 µL bacterial suspension from step 4 to column 2-11 in the designated microtiter plate according to Figure 1. In the gentamycin plate, the gentamycin has 2-fold dilution from 32ug/ml to 0.0156ug/ml Figure 2. The transfer of pathogens to microtiter plates should be completed within 30 min to maintain viable bacterial density.
Incubate the microtiter plates at 37 °C over night (19-20 h).
1.
A
B
C
D
E
F
G
H
I
J
K
L
M
1
2
3
4
5
6
7
8
9
10
11
12
A
medium blank
1-1
1-1
2-1
2-1
3-1
3-1
4-1
4-1
5-1
5-1
growth control
B
medium blank
1-2
2-2
2-2
3-2
3-2
4-2
4-2
5-2
5-2
5-2
growth control
C
medium blank
1-3
2-3
2-3
3-3
3-3
4-3
4-3
5-3
5-3
5-3
growth control
D
medium blank
1-4
2-4
2-4
3-4
3-4
4-4
4-4
5-4
5-4
5-4
growth control
E
medium blank
1-5
2-5
2-5
3-5
3-5
4-5
4-5
5-5
5-5
5-5
growth control
F
medium blank
1-6
2-6
2-6
3-6
3-6
4-6
4-6
5-6
5-6
5-6
growth control
G
medium blank
1-7
2-7
2-7
3-7
3-7
4-7
4-7
5-7
5-7
5-7
growth control
H
medium blank
1-8
2-8
2-8
3-8
3-8
4-8
4-8
5-8
5-8
5-8
growth control
Figure 1: The layout of 96-well microtiter plate for samples.
A
B
C
D
E
F
G
H
I
J
K
L
M
1
32ug/ml
2
16ug/ml
3
8ug/ml
4
4ug/ml
5
2ug/ml
6
1ug/ml
7
0.5ug/ml
8
0.25ug/ml
9
0.125ug/ml
10
0.63ug/ml
11
0.0315ug/ml
12
0.0156ug/ml
A
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
B
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
E. faecalis
C
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
D
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E. coli
E
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
F
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
P. aeruginosa
G
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
S. aureus
H
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
S. agalactiae
Figure 2: The layout of microtiter plate for antibiotic reference (gentamycin) control.
Day 3
Perform a visual inspection of the microtiter plates. Readings from plates where there are growth in column 1 or no growth in column 12 should not be reported as valid results. These assays will have to be repeated due to contamination, or insufficient growth of the pathogen.
Measure the absorbance in the wells using the Victor plate reader. Plates are read at OD600.
Results
Evaluation of results
The results are scored as Active (A), Inactive (I) or Questionable (Q) according to the measured absorbance.
A < 0.05
Q 0.05 - 0.09
I > 0.09
Protocol references
EUCAST Discussion document E.Dis 5.1. March 2003
European Committee for Antimicrobial Susceptibility Testing (EUCAST) of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID)