淋病奈瑟菌培养物回收率与解剖部位、标本采集时间和患者症状状态的关系。
Impact of Anatomic Site, Specimen Collection Timing, and Patient Symptom Status on Neisseria gonorrhoeae Culture Recovery.
机构信息
From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
City of Milwaukee Health Department, Milwaukee, WI.
出版信息
Sex Transm Dis. 2021 Dec 1;48(12S Suppl 2):S151-S156. doi: 10.1097/OLQ.0000000000001540.
BACKGROUND
Neisseria gonorrhoeae culture is required for antimicrobial susceptibility testing, but recovering isolates from clinical specimens is challenging. Although many variables influence culture recovery, studies evaluating the impact of culture specimen collection timing and patient symptom status are limited. This study analyzed urogenital and extragenital culture recovery data from Centers for Disease Control and Prevention's Strengthening the US Response to Resistant Gonorrhea (SURRG) program, a multisite project, which enhances local N. gonorrhoeae culture and antimicrobial susceptibility testing capacity.
METHODS
Eight SURRG jurisdictions collected gonococcal cultures from patients with N. gonorrhoeae-positive nucleic acid amplification test (NAAT) results attending sexually transmitted disease and community clinics. Matched NAAT and culture specimens from the same anatomic site were collected, and culture recovery was assessed. Time between NAAT and culture specimen collection was categorized as same day, 1 to 7 days, 8 to 14 days, or ≥15 days, and patient symptoms were matched to the anatomic site where culture specimens were collected.
RESULTS
From 2018 to 2019, among persons with N. gonorrhoeae-positive NAAT, urethral infections resulted in the highest culture recovery (5927 of 6515 [91.0%]), followed by endocervical (222 of 363 [61.2%]), vaginal (63 of 133 [47.4%]), rectal (1117 of 2805 [39.8%]), and pharyngeal (1019 of 3678 [27.7%]) infections. Culture recovery was highest when specimens were collected on the same day as NAAT specimens and significantly decreased after 7 days. Symptoms were significantly associated with culture recovery at urethral (P = <0.0001) and rectal (P = <0.0001) sites of infection but not endocervical, vaginal, or pharyngeal sites.
CONCLUSIONS
Culture specimen collection timing and patient symptomatic status can impact culture recovery. These findings can guide decisions about culture collection protocols to maximize culture recovery and strengthen detection of antimicrobial-resistant infections.
背景
淋球菌培养是进行抗菌药物敏感性测试所必需的，但从临床标本中恢复分离株具有挑战性。尽管许多变量会影响培养物的恢复，但评估培养标本采集时间和患者症状状态影响的研究有限。本研究分析了疾病控制与预防中心（CDC）强化美国耐药淋病应对（SURRG）计划的泌尿生殖道和生殖道外培养物恢复数据。该计划是一个多地点项目，增强了当地淋病奈瑟菌的培养和抗菌药物敏感性测试能力。
方法
8 个 SURRG 司法管辖区从接受性传播疾病和社区诊所就诊的淋病奈瑟菌核酸扩增试验（NAAT）阳性结果的患者中采集淋病奈瑟菌培养物。采集相同解剖部位的 NAAT 和培养标本，并评估培养物的恢复情况。NAAT 和培养标本采集的时间间隔分为同一天、1 至 7 天、8 至 14 天或≥15 天，患者症状与采集培养标本的解剖部位相匹配。
结果
2018 年至 2019 年，在淋病奈瑟菌 NAAT 阳性的人群中，尿道感染导致的培养物恢复率最高（6515 例中的 5927 例[91.0%]），其次是宫颈（363 例中的 222 例[61.2%]）、阴道（133 例中的 63 例[47.4%]）、直肠（2805 例中的 1117 例[39.8%]）和咽（3678 例中的 1019 例[27.7%]）感染。当标本与 NAAT 标本同一天采集时，培养物恢复率最高，在 7 天后显著下降。症状与尿道（P<0.0001）和直肠（P<0.0001）感染部位的培养物恢复显著相关，但与宫颈、阴道或咽部位的感染不相关。
结论
培养物标本采集时间和患者症状状态会影响培养物的恢复。这些发现可以指导培养物采集方案的决策，以最大限度地提高培养物的恢复率，并加强对耐抗菌药物感染的检测。
Zotero 插件