Indole test
Indole test is a biochemical test performed in microbiology to determine the ability of an organism to produce indole from the amino acid tryptophan. This test is significant in the identification and differentiation of members within the family Enterobacteriaceae, especially to distinguish Escherichia coli from other enteric bacteria. The presence of indole is indicative of the organism possessing the enzyme tryptophanase, which catalyzes the hydrolysis of tryptophan to indole, pyruvate, and ammonia.
Procedure
The indole test involves inoculating a tryptophan-rich medium with the test organism and allowing it to incubate for 24-48 hours. After incubation, a reagent (either Kovac’s or Ehrlich's reagent) is added to the culture. If indole is present, a red or pink color will develop in the reagent layer, indicating a positive result. A negative result is indicated by the absence of color change. The test is simple, cost-effective, and rapid, making it a popular choice for laboratory identification of bacteria.
Interpretation
- Positive indole test: A red or pink color appears in the reagent layer, indicating the presence of indole. This result is common for Escherichia coli.
 - Negative indole test: No color change in the reagent layer, indicating the absence of indole. This result is observed in bacteria that do not have the ability to produce indole from tryptophan, such as many species of Shigella and Enterobacter.
 
Clinical Significance
The indole test is particularly useful in the clinical laboratory for the identification of Escherichia coli, a common pathogen implicated in urinary tract infections, neonatal meningitis, and gastroenteritis. Differentiating E. coli from other gram-negative rods is a critical step in diagnosing infections and determining appropriate treatment strategies.
Limitations
While the indole test is valuable, it is not without limitations. False positives can occur if the reagent is old or contaminated. Additionally, the test's specificity and sensitivity may be influenced by the culture medium used and the incubation conditions. Therefore, the indole test should be used in conjunction with other biochemical tests for accurate bacterial identification.
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Contributors: Prab R. Tumpati, MD