ABSTRACT
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.
Subject(s)
Bacteria/isolation & purification , Bacteriological Techniques/methods , Epidemiological Monitoring , Groin/microbiology , Rectum/microbiology , Specimen Handling/methods , Brazil , Case-Control Studies , Epidemiologic Studies , Humans , Prospective Studies , Sensitivity and SpecificityABSTRACT
Os estafilococos coagulase-negativos (ECN) sao importantes agentes etiológicos das bacteremias hospitalares e freqüentemente considerados como contaminantes de hemoculturas. No período de outubro de 1990 a setembro de 1992, foram estudadas 300 hemoculturas positivas para ECN no Hospital Sao Paulo, sendo 141 bacteremias consideradas de origem hospitalar. Com o objetivo de diferenciar as bacteremias hospitalares verdadeiras das contaminantes por ECN, foram definidos critérios clínicos e microbiológicos. Apenas 20,6 por cento das bacteremias hospitalares por ECN foram consideradas como verdadeiras. A maior freqüência de recém-nascidos internados na unidade de terapia intensiva neonatal, a presença de cateter intravascular e a utilizaçao de nutriçao parenteral foram achados significativos. Nao houve diferença significante quanto a resistência a oxacilina e produçao de SLIME entre os ECN isolados das bacteremias verdadeiras e contaminantes. O critério clínico e a positividade da hemocultura até 48 horas após a incubaçao, utilizados em nossa definiçao, foram úteis para caracterizar as bacteremias verdadeiras por ECN.