VITEK 2 GP Card Instructions for Use
VITEK 2 GP Card Instructions for Use
VITEK® 2 GP
INTENDED USE
These Instructions for Use correspond to the VITEK® 2 Systems 7.01 and 8.01 software. If you are not using VITEK® 2
Systems 7.01 or 8.01 software, please refer to the VITEK® 2 Systems Product Information that you received with your current
software version.
The VITEK® 2 Gram-Positive identification card (GP) is intended for use with VITEK® 2 Systems for the automated
identification of most significant Gram-positive organisms. The VITEK® 2 GP identification card is a single-use disposable.
For a list of claimed species, see the Organisms Identified section.
DESCRIPTION
The GP identification card is based on established biochemical methods2,3,7,8,9,10,11,14,20,21,22,23,27,32,37,39 and newly
developed substrates. There are 43 biochemical tests measuring carbon source utilization, enzymatic activities and
resistance. Final identification results are available in approximately eight hours or less.
For a list of well contents, see the GP Well Contents table.
GP Well Contents
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Note: Other well numbers between 1 and 64 not designated in this table are empty.
PRECAUTIONS
Note: For industry customers that need assistance on selecting the correct VITEK® 2 identification card, please refer to the
VITEK® 2 Compact Instrument User Manual chapter, "Guidance to Select a VITEK® 2 Identification Card."
• For In Vitro Diagnostic Use Only.
• For US Only: Caution: US Federal Law restricts this device to sale by or on the order of a licensed practitioner.
• For professional use only.
• Suspensions not within the appropriate zone on the VITEK® 2 DensiCHEK™ Plus or the VITEK® 2 DensiCHEK™ may
compromise card performance.
• Do not use the card after the expiration date shown on the package liner.
• Store the card unopened in the package liner. Do not use the card if the protective package liner is damaged or if no
desiccant is present.
• Allow the card to come to room temperature before opening the package liner.
• Do not use powdered gloves. Powder may interfere with the optics.
• Use of culture media other than the recommended types must be validated by the customer laboratory for acceptable
performance.
• A Gram stain should be performed to determine an organism’s Gram reaction and morphology prior to selecting the
identification card to inoculate.
• The card performs as intended only when used in conjunction with VITEK® 2 Systems, following the instructions
contained in these Instructions for Use.
• Do not use glass test tubes. Use clear plastic (polystyrene) tubes only. Variation exists among test tubes of standard
diameter. Carefully place the tube into the cassette. If resistance is encountered, discard and try another tube that does
not require pressure to insert.
• Prior to inoculation, inspect cards for tape tears or damage to the tape and discard any that are suspect. Check the
saline level in the tubes after the cassette has been processed to ensure proper filling of card.
• VITEK® 2 60 or VITEK® 2 XL: Eject improperly filled cards.
• VITEK® 2 Compact: Do not load improperly filled cards.
• Give special consideration to specimen source and patient drug or antimicrobic regimen.
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• Interpretation of test results requires the judgment and skill of a person knowledgeable in microbial identification testing.
Additional testing may be required. (See the Supplemental Tests section.)
Warning: All patient specimens, microbial cultures, and inoculated VITEK® 2 cards, along with associated materials,
are potentially infectious and should be treated with universal precautions.30,35
Warning: All hazardous waste must be disposed of by following your local inspecting agency's guidelines.
STORAGE CONDITIONS
Upon receipt, store VITEK® 2 GP cards unopened in their original package liner at 2°C to 8°C.
SPECIMEN PREPARATION
For specimen preparation information, see the Culture Requirements Table.
VITEK® 2 Card Media Age of Culture1 Incubation Inoculum Dilution for AST Age of
Conditions Density Suspension
Before Loading
Instrument
GP TSAB2,3 12 to 48 hours 35°C to 37°C 0.50 to 0.63 N/A4 ≤30 minutes
McFarland
CBA2,3 5% to 10% CO2
Standard
TSA2,3 or aerobic, non
CO2
BP
CHBA
CHOC
CHOC PVX
CNT
CPS ID
MRSA ID
MSA
SAID
TSAHB
TSAL
VRE
GP and AST TSAB 18 to 24 hours 35°C to 37°C 0.50 to 0.63 280 μL in 3.0 < 30 minutes
GP pair CBA 5% to 10% CO2 McFarland mL saline
Standard
CPS ID or aerobic, non-
CO2
GP and AST ST TSAB 18 to 24 hours 35°C to 37°C 0.50 to 0.63 280 μL in 3.0 < 30 minutes
pair CBA 5% to 10% CO2
McFarland mL saline
Standard
1Cultures with scant or poor growth may give unidentified or incorrect results even when the Age of Culture requirements are
met.
2These media were used in the identification product database development and will give optimal performance.
3OMA Official Methods of Analysis validated medium.
4N/A = not applicable
Culture Requirements Table — Media Abbreviations
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BP = Baird Parker
CBA = Columbia Blood Agar with 5% Sheep Blood
CHBA = Columbia Horse Blood Agar
CHOC = Chocolate Agar
CHOC PVX = Chocolate Polyvitex
CNT = Count-TACT®
CPS ID = chromID™ CPS (CPS ID agar)
MRSA ID = chromID™ (MRSA ID Agar)
MSA = Mannitol Salt Agar
SAID = chromID™ S. aureus (S. aureus ID Agar)
TSA = Trypticase Soy Agar
TSAB = Trypticase Soy Agar with 5% Sheep Blood
TSAHB = Trypticase Soy Agar with 5% Horse Blood
TSAL = TSA with Lecithin and P80
VRE = chromID™ VRE
TEST PROCEDURE
Materials
When used with VITEK® 2 instrumentation, the GP card is a complete system for routine identification testing of most
clinically significant Gram-positive organisms.
Required materials are:
• VITEK® 2 GP Card
• VITEK® 2 DensiCHEK™ Plus Kit or VITEK® 2 DensiCHEK™ Kit
• DensiCHEK™ Plus Standards Kit or DensiCHEK™ Standards Kit
• VITEK® 2 Cassette
• Sterile saline (aqueous 0.45% to 0.50% NaCl, pH 4.5 to 7.0)
• 12 mm x 75 mm clear plastic (polystyrene) disposable test tubes
• Sterile sticks or swabs
• Appropriate agar medium (see Culture Requirements table).
Optional accessories:
• Adjustable volume saline dispenser
• Loops
• Pre-dispensed saline test tubes (aqueous 0.45% to 0.50% NaCl, pH 4.5 to 7.0)
• Test tube caps
• Vortex
Procedure
Warning: Failure to follow instructions and recommendations provided in this section for performing laboratory
tasks may cause erroneous or delayed results.
For product-specific information, see the Culture Requirements table.
Note: Prepare the inoculum from a pure culture, according to good laboratory practices. In case of mixed cultures, a re-
isolation step is required. It is recommended that a purity check plate be done to ensure that a pure culture was used for
testing.
1. Do one of the following:
• Select isolated colonies from a primary plate if culture requirements are met.
• Subculture the organism to be tested to appropriate agar medium and incubate accordingly.
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2. Aseptically transfer 3.0 mL of sterile saline (aqueous 0.45% to 0.50% NaCl, pH 4.5 to 7.0) into a clear plastic
(polystyrene) test tube (12 mm x 75 mm).
3. Use a sterile stick or swab to transfer a sufficient number of morphologically similar colonies to the saline tube prepared in
step 2. Prepare a homogenous organism suspension with a density equivalent to a McFarland No. 0.50 to 0.63 using a
calibrated VITEK® 2 DensiCHEK™ Plus or VITEK® 2 DensiCHEK™.
Note: Age of suspension must not exceed 30 minutes before inoculating card.
4. Place the suspension tube and GP card in the cassette.
5. Refer to the appropriate Instrument User Manual for instructions on data entry and how to load the cassette into the
instrument.
6. Follow your local inspecting agency's guidelines for disposal of hazardous waste.
RESULTS
Identification Analytical Techniques
VITEK® 2 Systems identify an organism by using a methodology based on the characteristics of the data and knowledge
about the organism and reactions being analyzed. Sufficient data have been collected from known strains to estimate the
typical reactions of the claimed species to a set of discriminating biochemicals. If a unique identification pattern is not
recognized, a list of possible organisms is given, or the strain is determined to be outside the scope of the database.
The printed lab report contains suggestions for any supplemental tests necessary to complete the identification. If the tests
are not sufficient to complete the identification, then standard microbiology references and literature should be consulted.
Certain species may belong to slashline (mixed) taxa identification. This occurs when the biopattern is the same for the
taxa listed. Supplemental tests may be used to separate slashline taxa. The species in the GP Slashline Taxa table belong to
the GP slashline taxa.
GP Slashline Taxa
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PERCENT PROBABILITY
As part of the identification process, the software compares the test set of reactions to the expected set of reactions of each
organism, or organism group, that can be identified by the product. A quantitative value, the percent probability, is calculated
and relates to how well the observed reactions compare to the typical reactions of each organism. A perfect match between
the test reaction pattern and the unique reaction pattern of a single organism, or organism group, would provide a percent
probability of 99. When a perfect match is not obtained, it is still possible for the reaction pattern to be sufficiently close to that
of an expected reaction pattern such that a clear decision can be provided about the organism identification. The range of
percent probabilities in the one-choice case is 85 to 99. Values closer to 99 indicate a closer match to the typical pattern for
the given organism.
When the reaction pattern is not sufficient to discriminate between two to three organisms, the percent probabilities reflect
this ambiguity. The reported probability values indicate, relatively, the order in which the reaction pattern best corresponds to
the listed possibilities. The order does not, however, suggest that the pattern match to one of the possible identifications is
clearly superior to another. The probability characteristic of an overall sum of 100 is retained through the calculation process.
After resolution to one choice, the probability characteristic of the single choice is retained.
ADDITIONAL INFORMATION ON LAB REPORT
Supplemental test — External (offline) test that allows the user to resolve a slashline or Low Discrimination identification.
Numbers in parentheses indicate percent positive reaction for the species/test listed.
Contraindicating test — Test result that is unusual for a reported taxon.
Taxa Note
Enterococcus durans Possibility of Enterococcus villorum if veterinary.
Listeria monocytogenes Critical pathogen, check CAMP test and beta hemolysis.
The species identified may have significance to patient or
sample outcome and can be stopped for review.
Staphylococcus warneri Possibility of Staphylococcus pasteuri if yellow pigmented.
For 8.01 Software Users
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Taxa Note
Listeria innocua Possibility of Listeria monocytogenes.
Check for beta hemolysis. Listeria innocua strains are non-
hemolytic.
Notes Associated with an Improperly Filled Card or with a Negative Profile (Biopattern)
• For the case where the time between two readings is greater than 40 minutes: “CARD ERROR — Missing data.”
• For the case where there is a negative profile: “Organism with low reactivity biopattern — please check viability.”
• When a biopattern is calculated for an unknown organism that is completely negative or consists of both negative tests
and tests that fall within the uncertainty zone, the identification call will be “Non or low reactive biopattern.”
The following species could potentially trigger this note if a test was atypical or fell within the uncertainty zone:
• Alloiococcus otitis
• Dermacoccus nishinomiyaensis
• Gemella bergeri
• Kocuria rosea
• Kocuria varians
• Kytococcus sedentarius
• Leuconostoc mesenteroides ssp. cremoris
• Micrococcus lylae
• Staphylococcus auricularis
• Streptococcus pluranimalium
QUALITY CONTROL
Quality control organisms and their expected results are listed in the VITEK® 2 GP Quality Control Tables. Process these
according to the procedure for test isolates outlined in this document.
Certification Statement
This is to certify that bioMérieux complies with ISO 13485 and FDA Quality System Regulation (QSR) requirements for
design, development, and manufacture of microbial identification systems.
Frequency of Testing
Currently, it is recommended that you use your most stringent inspecting agency’s guidelines for frequency of identification
product testing.
Common practice is to perform QC upon receipt of shipment of the test kits. Reactions must follow Instructions for Use
results.
If the results do not meet the criteria, subculture for purity and repeat the test. If discrepant results are repeated, perform an
alternate identification method and contact bioMérieux.
Testing and Storage of QC Organisms
1. Rehydrate the organism according to the manufacturer's instructions.
2. Use Trypticase Soy with 5% sheep blood agar (TSAB) and incubate at 35°C to 37°C in 5% to 10% CO2 for approximately
18 to 24 hours.
3. Check for purity. Perform second subculture for testing.
Short-Term Storage Conditions
1. Subculture to a TSAB plate or slant.
2. Incubate for 24 hours at 35°C to 37°C in 5% to 10% CO2.
3. Refrigerate at 2°C to 8°C for up to two weeks.
4. Subculture once as described above and use for QC.
Long-Term Storage Conditions
1. Make a heavy suspension in Tryptic Soy Broth (TSB) with 15% glycerol.
2. Freeze at -70°C.
3. Subculture to TSAB twice before running QC.
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Note: Avoid repeated thawing and refreezing by either freezing in single-use aliquots or removing a small portion of frozen
organism preparation with a sterile applicator stick.
STREAMLINED QUALITY CONTROL
Note: Industrial Use Only laboratories should perform quality control following the Streamlined Quality Control section. No
additional testing is required for these users.
As there are no substrates that are consistently sensitive to degradation during shipping conditions, streamlined quality
control may be conducted by testing two strains: one that is mostly positive and the other, which is mostly negative for
reactions on GP. (See GP Quality Control tables for more details.)
COMPREHENSIVE QUALITY CONTROL
Customers who do not qualify for streamlined quality control testing are required to perform comprehensive quality control
testing, which entails demonstration of a positive and negative reaction for each substrate of an identification product.6
In order to qualify initially for streamlined quality control testing, the CLSI® M50-A standard requires that the user perform and
document either of the following:5
• Verification testing to show that performance is equivalent to the manufacturer's claims.
• Comprehensive quality control testing of at least three lots over at least three different seasons.
Refer to the complete CLSI® M50-A standard for information regarding continued qualification and further details of
requirements and responsibilities for both the user and the manufacturer related to streamlined quality control testing.
GP Quality Control Tables:
Enterococcus casseliflavus ATCC® 700327™ (for streamlined or comprehensive quality control)
Streptococcus salivarius ssp. thermophilus ATCC® 19258™ (for comprehensive quality control)
Kocuria kristinae ATCC® BAA-752™ (for comprehensive quality control)
Listeria monocytogenes ATCC® BAA-751™ (for comprehensive quality control)
Streptococcus pneumoniae ATCC® 49619™ (for comprehensive quality control)
Staphylococcus saprophyticus ATCC® BAA-750™ (for streamlined or comprehensive quality control)
Staphylococcus sciuri ATCC® 29061™ (for comprehensive quality control)
Streptococcus equi ssp. zooepidemicus ATCC® 43079™ (for comprehensive quality control)
Enterococcus saccharolyticus ATCC® 43076™ (for comprehensive quality control)
The GP card typically identifies the quality control organisms as one-choice or within a low discrimination or slashline
identification. However, strains are chosen for reaction performance over identification performance. Therefore, an
unidentified or misidentified result may occur when all expected quality control reactions are correct.
QC Organism: Enterococcus casseliflavus ATCC® 700327™ (for streamlined or comprehensive quality control)
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QC Organism: Streptococcus salivarius ssp. thermophilus ATCC® 19258™ (for comprehensive quality control)
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QC Organism: Staphylococcus saprophyticus ATCC® BAA-750™ (for streamlined or comprehensive quality control)
QC Organism: Streptococcus equi ssp. zooepidemicus ATCC® 43079™ (for comprehensive quality control)
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• Leuconostoc citreum
• Leuconostoc lactis
• Leuconostoc mesenteroides ssp. cremoris
• Leuconostoc mesenteroides ssp. dextranicum
• Leuconostoc mesenteroides ssp. mesenteroides
• Leuconostoc pseudomesenteroides
• Listeria grayi+
• Listeria innocua+
• Listeria ivanovii+
• Listeria monocytogenes+
• Listeria seeligeri+
• Listeria welshimeri+
• Micrococcus luteus
• Micrococcus lylae
• Pediococcus acidilactici
• Pediococcus pentosaceus
• Rothia dentocariosa
• Rothia mucilaginosa
• Staphylococcus arlettae
• Staphylococcus aureus *+
• Staphylococcus auricularis
• Staphylococcus capitis
• Staphylococcus caprae
• Staphylococcus carnosus ssp. carnosus
• Staphylococcus chromogenes
• Staphylococcus cohnii ssp. cohnii
• Staphylococcus cohnii ssp. urealyticus
• Staphylococcus epidermidis+
• Staphylococcus equorum
• Staphylococcus gallinarum
• Staphylococcus haemolyticus
• Staphylococcus hominis ssp. hominis
• Staphylococcus hominis ssp. novobiosepticus
• Staphylococcus hyicus+
• Staphylococcus intermedius+
• Staphylococcus kloosii
• Staphylococcus lentus
• Staphylococcus lugdunensis
• Staphylococcus pseudintermedius
• Staphylococcus saprophyticus
• Staphylococcus schleiferi
• Staphylococcus sciuri
• Staphylococcus simulans
• Staphylococcus vitulinus
• Staphylococcus warneri
• Staphylococcus xylosus
• Streptococcus agalactiae
• Streptococcus alactolyticus
• Streptococcus anginosus
• Streptococcus canis
• Streptococcus constellatus ssp. constellatus
• Streptococcus constellatus ssp. pharyngis
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• Streptococcus cristatus
• Streptococcus downei
• Streptococcus dysgalactiae ssp. dysgalactiae
• Streptococcus dysgalactiae ssp. equisimilis
• Streptococcus equi ssp. equi
• Streptococcus equi ssp. zooepidemicus
• Streptococcus equinus
• Streptococcus gallolyticus ssp. gallolyticus
• Streptococcus gallolyticus ssp. pasteurianus
• Streptococcus gordonii
• Streptococcus hyointestinalis
• Streptococcus infantarius ssp. coli (formerly known as Streptococcus lutetiensis)
• Streptococcus infantarius ssp. infantarius
• Streptococcus intermedius
• Streptococcus mitis/Streptococcus oralis
• Streptococcus mutans
• Streptococcus ovis
• Streptococcus parasanguinis
• Streptococcus pluranimalium
• Streptococcus pneumoniae
• Streptococcus porcinus
• Streptococcus pseudoporcinus
• Streptococcus pyogenes
• Streptococcus salivarius ssp. salivarius
• Streptococcus salivarius ssp. thermophilus
• Streptococcus sanguinis
• Streptococcus sobrinus
• Streptococcus suis I
• Streptococcus suis II
• Streptococcus thoraltensis
• Streptococcus uberis
• Streptococcus vestibularis
• Vagococcus fluvialis
GP Supplemental Tests
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among the different phenotypes of Streptococcus dysgalactiae strains. Int. J. Syst. Bacteriol. 1998. 48:1231-1243.
38. Von Graevenitz, A. Rothia dentocariosa: taxonomy and differential diagnosis. [Link]. and Infection, 2004.
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39. Whiley RA, Hall LMC, Hardie JM, Beighton D. A study of small colony beta hemolytic, Lancefield group C streptococci
within the anginosus group: description of Streptococcus constellatus subsp. pharyngis [Link]., associated with the
human throat and pharyngitis. Int. J. Syst. Bacteriol. 1999. 49:1443-1449.
Use this Instructions for Use with VITEK® 2 Product No. 21342.
INDEX OF SYMBOLS
Symbol Meaning
Catalog number
Legal Manufacturer
Temperature limitation
Use by date
Batch code
Date of manufacture
bioMérieux - English - 18
VITEK® 2 GP 043900- 02 - en - 2016-10
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This product may be protected by one or more patents, see: [Link]
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