Active surveillance cultures: comparison of inguinal and rectal sites for detection of multidrug-resistant bacteria

• Published in: The Journal of hospital infection Vol. 92; no. 2; pp. 178 - 182
• Main Authors: Stier, C.J.N, Paganini, M.C, de Souza, H.H.M, Costa, L.M.D, dos Santos, G.S, Cruz, E.D.A
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.02.2016
• Subjects: Bacteria - isolation & purification; Bacteriological Techniques - methods; Brazil; Carrier state; Case-Control Studies; Colonization; Drug resistance; Epidemiologic Studies; Epidemiological Monitoring; Epidemiological surveillance; Groin - microbiology; Humans; Infectious Disease; Prospective Studies; Rectum - microbiology; Sensitivity and Specificity; Specimen Handling - methods; Epidemiological surveillance; Carrier state; Drug resistance; Colonization
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2015.11.008

Summary Background Rectal swabs are the most widely used surveillance technique for detecting multidrug-resistant bacteria colonizing the intestinal tract. Obtaining these samples may cause embarrassment and discomfort to patients. Prior studies indicate that perirectal swabs are as sensitive and specific as rectal swabs with greater patient acceptance. Aim To compare inguinal and rectal swabs for the detection of multidrug-resistant bacteria colonizing the intestinal tract. Methods An epidemiological, comparative, prospective, and controlled study was undertaken with 102 Brazilian patients. Inguinal and rectal swabs were collected for culture and compared. Findings Compared to rectal swabs, the sensitivity and specificity of inguinal swabs was 91.8% and 88.7%, respectively. Even when there were low colony counts from rectal samples, there were more than 100 colonies from inguinal samples. Conclusion The inguinal region can be considered an acceptable alternative for collecting surveillance cultures for multidrug-resistant bacteria colonizing the intestinal tract. The inguinal swab technique is sensitive and specific for assessing multidrug-resistant micro-organisms, less embarrassing for patients, and simple to implement in hospital practice.