I
24 h
glucose, sucrose, glycoge
-cystinose (H,S)
- urease
Smear
I The first information in the
3swobS from the { isolation 9[-liz;;$T, medium colonies with b r w n halo
lesion
(I hrwt,
skin,
indication for the diagnosis
wound
Enrichment in
of C. diphlherioe species
etc.)
ECST medium
Slide agglutination
I swab __3 Enrichment \ lonies with brown halo
from the nose
in ECST
are picked on LoefflerIsolation on Tinsdale medium
medium
ISOLATION
nose + Enrichment
/
medium
fromi
-
Jsolation on
I Tinsdale medium
\
k t h r o a t +Enrichment
in ECST
medium '
(Skin lesion)
48h
.
I
D E N T I
F I
C A T I
O N *
)
by:
-smear
-carbohydrate hydrolysis:
glucose, sucrose, glycogen
-cystinase (H,S)
- urease
- toxinogenicity in wilro
by Elek-test
colonies with brown holo
+ smear
indication for the diagnosis
of C. diphfherioe Species
decision to isolate carrier
Colonies with brown halo
are picked up on Loeffler7 2 h
RESULT
Firm diagnosis on:
C. d@Mherioe species
biochemical type
toxinogenesis
I D E N T I F I C A T I O N by:
k
96 h
RESULT
Firm diagnosis on:
C. diphlherioe Species
biochemicol type
toxinogenesis
phage - type
FIG. 37. Timetable of microbiological diagnosis in C. diphtheriae. ECST = Egg-cystine-serum-tellurite broth.
*The identification could be effected in hospitals or public health laboratories.
""Toxigenicity could also be performed in vivo subcutaneously in guinea pig or rabbit skin test.