Alkaline peptone water (APW) is recommended as an enrichment broth for isolating Vibrio cholerae from clinical and non-clinical samples (suspected food & water samples). Many broth media have been described for the enrichment of V. cholerae, including Monsur’s enrichment medium and modification of APW with added potassium tellurite. Still, they may not offer a selective advantage over APW if used with a short incubation time (6 to 8 hours).
Enrichment media are liquid culture media which contain substances that inhibit the growth of unwanted organisms.
Enrichment broth should always be used with
- convalescent patients,
- suspected asymptomatic infections,
- environmental specimens, and
- whenever high numbers of competing organisms are likely to present in the specimen.
but when the patient is in the very early stages of illness and is passing liquid stool, it may not be necessary to enrich stool specimens.
Table of Contents
Principle
Vibrio spp grow very rapidly in APW and, at 6 to 8 hours, will be present in greater numbers than non-Vibrio organisms. Enrichment in APW enhances the isolation of V. cholerae O1 when few organisms are present, as in specimens from convalescent patients and asymptomatic carriers.
Composition
Alkaline peptone water is made by dissolving peptone and sodium chloride in distilled water.
Ingredients | Gram/Liter |
Peptone | 10 gm |
Sodium chloride | 10 gm |
Distilled water | 1000 ml |
Preparation of Alkaline Peptone Water
- To make about 50 bottles (i.e. 500 ml), you will need 5 g of peptone and 5 g of Sodium chloride.
- Dissolve the peptone and sodium chloride in the water.
- Adjust the reaction of the medium to pH 8.6 to 9.0 using 1 mol/L sodium hydroxide.
- Dispense the medium in 10 ml amounts in screw-cap bottles.
- Sterilize by autoclaving (with caps loosened) at 121°C for 15 minutes. Tighten the bottle caps after the medium has cooled.
- Date the medium and give it a batch number. Label the bottles and record on each the expiry date of the medium (2 years from preparation).
- Store in a cool dark place with the bottle caps screwed tightly to prevent a change in pH.
pH of the medium (pH 8.6 ± 0.2 @ 25°C)
Shelf-life: Up to 2 years providing there is no change in the volume or appearance of the medium suggesting contamination.
Uses
- Alkaline peptone water (APW) is an enrichment medium for Vibrio cholerae. Its alkalinity suppresses the growth of intestinal commensals, and V.cholerae grows rapidly. Prior enrichment in APW is unnecessary if the sample contains many vibrios (e.g., acute cholera).
- APW is a useful transport medium for Vibrio cholerae. APW is an excellent transport and enrichment medium for V. cholerae but unsuitable for other enteric pathogens.
Inoculation
APW can be inoculated with liquid stool, fecal suspension, or a rectal swab.
A. For use as an enrichment medium:
- Inoculate the APW bottle with a specimen (The stool inoculums should not exceed 10% of the volume of the broth)
- Incubate the tube with the cap loosened at 35°C to 37°C for 6 to 8 hours.
- After 6 to 8 hours of incubation, subcultures to TCBS should be made with one to two loopful of APW from the surface and topmost portion of the broth, since vibrios preferentially grow in this area.
- Do not shake or mix the tube before subculturing.
- If the broth cannot be subcultured after 6 to 8 hours of incubation, subculture at 18 hours to a fresh tube of APW.
- This second tube should be subcultured to a solid medium after 6 to 8 hours of incubation.
B. For use as a transport medium
- When cholera is suspected, transfer about 1 ml of the specimen into 10 ml of sterile alkaline peptone water.
- The inoculated medium should reach the laboratory within 8 hours of collection (Proteus species will grow eventually in alkaline peptone water.)
Growth and further processing
Vibrio cholerae grows rapidly on APW, producing turbidity on and just below the surface of the medium within 4-6 hours. To confirm that the organisms are vibrios, examine a wet preparation/ perform hanging drop motility test, prepare gram stain of the smear (which may show gram-negative curved bacilli) and/or culture in the TCBS medium.
If the test for detecting Vibrio cholerae lipopolysaccharide antigen in the stool sample is done after enrichment in APW, its sensitivity and specificity increase.
References and further readings:
- Cheesbrough M., District Laboratory Practice in Tropical Countries: Part 2:Cambridge University Press.
- Laboratory Methods for the Diagnosis of Vibrio cholerae; Centers for Disease Control and Prevention
Increase the number of illustrations
What is the difference between alkaline peptone and peptone water?
the addition of a another salt i.e. sodium hydroxide in this case. normal peptone water lacks NaOH therefore has a lower pH
what is the best transport media in low income countries: stuart or charcoal stuart?