Antibiotic-Resistant Research, 2014
Centers for Disease Control (CDC) microbiologist Johannetsy Avillan holding up an opened Petri dish culture plate, demonstrating the results of a modified Hodge test (MHT), which is used to identify resistance in bacteria known as Enterobacteriaceae. Bacteria that are resistant to carbapenems (Carbapenem-Resistant Enterobacteriaceae (CRE)), which are considered "last resort" antibiotics, produce a distinctive clover-leaf shaped growth pattern, as seen in this case. The distinctive clover-leaf shaped regions seen on the culture dish develop under the following conditions. The dish is first inoculated with a culture of carbapenem-susceptible Escherichia coli bacteria. Next, a carbapenen laden susceptibility disk is placed atop the medium, followed by streaking the dish with the test organism from each disk outwardly, in a star-like pattern. If the test organism is a strain that is able to produce carbapenemase, it can then render the carbapenen antimicrobial agent contained in the disk ineffective, in which case, the carbapenen-susceptible E. coli bacteria, can grow along the test microbial streaks, thereby, forming the classic clover-leaf pattern.
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