Journal Article

High Rate of False-Negative Results of the Rectal Swab Culture Method in Detection of Gastrointestinal Colonization with Vancomycin-Resistant Enterococci

Erika M. C. D Agata, Shiva Gautam, William K. Green and Yi-Wei Tang

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 2, pages 167-172
Published in print January 2002 | ISSN: 1058-4838
Published online January 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/338234
High Rate of False-Negative Results of the Rectal Swab Culture Method in Detection of Gastrointestinal Colonization with Vancomycin-Resistant Enterococci

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The diagnostic accuracy of the rectal swab (RS) culture method in identifying gastrointestinal colonization with vancomycin-resistant enterococci (VRE) is not known. Serial quantitative stool cultures, skin cultures, and RS cultures were performed for patients with VRE infections to assess the false-negative rate of the RS and the prevalence of skin colonization, a prerequisite for cross-transmission, at varying VRE stool densities. A total of 35 stool samples were obtained from 13 patients. The sensitivity of the RS culture was 58%; it ranged from 100%, at VRE densities of ⩾7.5 log10 colony forming units (cfu) per gram of stool, to 0%, at densities of ⩽4.5 log10 cfu per gram of stool. Skin colonization was detected at these low VRE stool densities, but it was more common at higher VRE densities (P < .001). Antibiotic exposure was significantly associated with higher VRE stool densities (P < .001). The high false-negative rate of the RS may be contributing to the continued increase in the prevalence of VRE.

Journal Article.  3623 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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