Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA.
NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA.
J Clin Microbiol. 2022 Jul 20;60(7):e0023422. doi: 10.1128/jcm.00234-22. Epub 2022 Jun 13.
Stool specimens are frequently used to detect gastrointestinal tract colonization with antimicrobial-resistant enteric bacteria, but they cannot be rapidly collected. Perianal swab specimens can be collected more quickly and efficiently, but data evaluating their suitability as a specimen type for this purpose are sparse. We performed selective culture for extended-spectrum β-lactamase-producing (ESBL-E) and fluoroquinolone-resistant (FQRE) using paired perianal swab and stool specimens that were collected within 1 day of each other from hematopoietic cell transplant recipients and patients with acute leukemia. Nineteen (7.6%) of 251 stool specimens yielded ESBL-E and 64 (26%) of 246 stool specimens yielded FQRE. The positive percent agreement of perianal swab specimens compared to stool specimens was 95% (18/19; 95% confidence interval [CI], 74% to 100%) for detecting ESBL-E and 95% (61/64; 95% CI, 87% to 99%) for detecting FQRE. The concordance between specimen types was 98% (95% CI, 97% to 100%). Perianal swabs are a reliable specimen type for surveillance of the gastrointestinal tract for ESBL-E and FQRE.
粪便标本常用于检测胃肠道中具有抗微生物药物耐药性的肠道细菌的定植情况，但无法快速采集。肛周拭子标本可更快、更有效地采集，但用于评估其作为该目的标本类型的适用性的数据却很少。我们对造血细胞移植受者和急性白血病患者在同一天内采集的配对肛周拭子和粪便标本进行了扩展谱β-内酰胺酶产生（ESBL-E）和氟喹诺酮耐药（FQRE）的选择性培养。251 份粪便标本中有 19 份（7.6%）产生了 ESBL-E，246 份粪便标本中有 64 份（26%）产生了 FQRE。与粪便标本相比，肛周拭子标本检测 ESBL-E 的阳性符合率为 95%（18/19；95%置信区间 [CI]，74%至 100%），检测 FQRE 的阳性符合率为 95%（61/64；95% CI，87%至 99%）。两种标本类型的一致性为 98%（95% CI，97%至 100%）。肛周拭子是用于监测胃肠道中 ESBL-E 和 FQRE 的可靠标本类型。
