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There is no standardized method for doing this test. Some investigators prepare the inoculum in different ways. Some interpret the test according to the presence or absence of an indentation in the inhibition zone. Some use the presence or absence of growth up to the antibiotic test to interpret the test.
A recent paper about the continuing evolution of the methodology is Yong, D., R. Park, J. Yum, K. Lee, E. Choi, and Y. Chong. 2002. Further modification of the Hodge test to screen AmpC beta-lactamase (CMY-1)-producing strains of Escherichia coli and Klebsiella pneumoniae. J Microbiol Methods 51:407.
If you wish to use it to detect carbapenemases and use an imipenem disk, beware of false positive results in tests with isolates that produce a high level of AmpC.
The name "Hodge test" is a misnomer. It was previously known as the clover leaf test, but this has been forgotten.
Reig, M., and F. Baquero. 1984. Limitations in the use of the clover leaf test in Bacteroides species. Eur J Clin Microbiol 3:561-563.
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