Comparison between Perianal Swab and Stool Specimens for Detecting Colonization with Extended-Spectrum Beta-Lactamase-Producing and Fluoroquinolone-Resistant Enterobacterales.

TitleComparison between Perianal Swab and Stool Specimens for Detecting Colonization with Extended-Spectrum Beta-Lactamase-Producing and Fluoroquinolone-Resistant Enterobacterales.
Publication TypeJournal Article
Year of Publication2022
AuthorsKubiak JM, Hovan M, Davidson E, Douglass C, Burgos K, Walsh TJ, Westblade LF, Satlin MJ
JournalJ Clin Microbiol
Volume60
Issue7
Paginatione0023422
Date Published2022 Jul 20
ISSN1098-660X
KeywordsAnti-Bacterial Agents, beta-Lactamases, Enterobacteriaceae, Fluoroquinolones, Gastrointestinal Tract, Hematopoietic Stem Cell Transplantation, Humans
Abstract

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 Enterobacterales (ESBL-E) and fluoroquinolone-resistant Enterobacterales (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.

DOI10.1128/jcm.00234-22
Alternate JournalJ Clin Microbiol
PubMed ID35695506
PubMed Central IDPMC9297816
Grant ListK23 AI114994 / AI / NIAID NIH HHS / United States
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