Active surveillance cultures: comparison of inguinal and rectal sites for detection of multidrug-resistant bacteria

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.

Keywords: Carrier state; Colonization; Drug resistance; Epidemiological surveillance.