Aerobic Gram Negative Rods Flowchart

Gram Stain = Gram Negative Rods

NOTE or Gram Negative Coccobacilli
Exceptions do exist to these general rules

* = See Biochemical Tests for Gram Negative Growth on MacConkey Agar

Organism ID Job aid for positive and negative
result reference. Yes No

Lactose fermentation Growth on

on Mac Blood Agar

Lactose Fermenter Lactose Non-fermenter Yes No

Indole test – used for Oxidase Test – used for Brucella spp., Growth on
presumptive ID only – Full presumptive ID only – Full Francisella spp., CHOC
Identification necessary Identification necessary Eikenella spp.,
Pasteurella spp.,
Capnocytophaga Probable
Haemophilus
Indole (+)* Indole (-)* Oxidase (+)* Oxidase (-)* spp.

Cronobacter spp. , Rule in/Rule out

Pseudomonas spp., Acinetobacter spp., procedure for BT
Escherichia coli,
Klebsiella Alcaligenes spp., Vibrio Stenotrophomonas agents:
Klebsiella pneumoniae, spp., Aeromonas spp., spp., Francisella spp:
oxytoca, Burkholderia spp.-
Enterobacter Proteus spp., Oxidase negative,
Citrobacter aerogenes, variable
Yersinia spp., Catalase negative
diversus,
Enterobacter or weakly positive
Edwardsiella cloacae, Salmonella spp.,
tarda Rule in/Rule out Brucella spp:
Hafnia alvei Shigella spp., Oxidase positive,
procedure for BT agents:
Burkholderia mallei – non- B. mallei Urease positive,
motile, Burkholderia Catalase positive
pseudomallei – motile,
Both organisms are Indole If probable B. mallei,
negative and Colistin use rule in/rule out
resistant procedure to left

Laboratory Training Branch