Initial Observation and Interpretation of Cultures
Clockwise from the top—CHOC, BAP, and MAC—large gram-negative rods (enterics) grow on all plates, appearing larger and mucoid on BAP and CHOC, while smaller grayish-brown colonies are fastidious Haemophilus growing on CHOC (arrow), which are not growing on BAP or MAC.
•While MAC agar supports most gram-negative rods, esp. Enterobacteriaceae, but inhibits gram-positive and some fastidious gram-negatives (e.g., Haemophilus, Neisseria).
•Therefore, growth on BAP and CHOC but not MAC suggests a gram-positive or fastidious gram-negative organism.
•Gram-negative rods often appear similar on BAP and CHOC, producing large gray or mucoid colonies; hemolysis is seen only on BAP
•MAC is ideal for characterizing gram-negative rods, differentiating lactose fermenters (pink) from nonfermenters (colorless).
•Some enteric pathogens (e.g., Escherichia/Citrobacter) produce dry pink colonies with a pink bile salt halo.
•Others (e.g., Klebsiella/Enterobacter) form large, mucoid pink colonies, sometimes with cream-colored centers; these features aid presumptive identification.
A, Lactose-fermenting Escherichia/Citrobacter-like organisms growing on MAC. Notice the dry appearance of the colony and the pink precipitate of bile salts extending beyond the periphery of the colonies. B, Close-up of dry, flat Escherichia/Citrobacter-like lactose fermenters growing on MAC.