Meatal Swabs Contain Less Cellular Material and Are Associated with a Decrease in Gram Stain Smear Quality Compared to Urethral Swabs in Men

dc.contributor.authorJordan, Stephen J.
dc.contributor.authorSchwebke, Jane R.
dc.contributor.authorAaron, Kristal J.
dc.contributor.authorVan Der Pol, Barbara
dc.contributor.authorHook, Edward W., III
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2017-12-08T17:42:00Z
dc.date.available2017-12-08T17:42:00Z
dc.date.issued2017-07
dc.description.abstractUrethral swabs are the samples of choice for point-of-care Gram stain testing to diagnose Neisseria gonorrhoeae infection and nongonococcal urethritis (NGU) in men. As an alternative to urethral swabs, meatal swabs have been recommended for the collection of urethral discharge to diagnose N. gonorrhoeae and Chlamydia trachomatis infection in certain populations by nucleic acid amplification testing (NAAT), as they involve a less invasive collection method. However, as meatal swabs could be sampling a reduced surface area and result in fewer collected epithelial cells compared to urethral swabs, the adequacy of meatal swab specimens to collect sufficient cellular material for Gram stain testing remains unknown. We enrolled 66 men who underwent either urethral or meatal swabbing and compared the cellular content and Gram stain failure rate. We measured the difference in swab cellular content using the Cepheid Xpert CT/NG sample adequacy control crossing threshold (SACCT) and determined the failure rate of Gram stain smears (GSS) due to insufficient cellular material. In the absence of discharge, meatal smears were associated with a significant reduction in cellular content (P = 0.0118), which corresponded with a GSS failure rate significantly higher than that for urethral swabs (45% versus 3%, respectively; P < 0.0001). When discharge was present, there was no difference among results from urethral and meatal swabs. Therefore, if GSS testing is being considered for point-of-care diagnosis of N. gonorrhoeae infection or NGU in men, meatal swabs should be avoided in the absence of a visible discharge.en_US
dc.eprint.versionAuthor's manuscripten_US
dc.identifier.citationJordan, S. J., Schwebke, J. R., Aaron, K. J., Van Der Pol, B., & Hook, E. W. (2017). Meatal Swabs Contain Less Cellular Material and are Associated with a Decrease in Gram Stain Smear Quality Compared to Urethral Swabs in Men. Journal of Clinical Microbiology, JCM-00423. http://dx.doi.org/10.1128/JCM.00423-17en_US
dc.identifier.urihttps://hdl.handle.net/1805/14768
dc.language.isoenen_US
dc.publisherASMen_US
dc.relation.isversionof10.1128/JCM.00423-17en_US
dc.relation.journalJournal of Clinical Microbiologyen_US
dc.rightsIUPUI Open Access Policyen_US
dc.sourceAuthoren_US
dc.subjectChlamydia trachomatisen_US
dc.subjectgram stainen_US
dc.subjectmeatal swabsen_US
dc.titleMeatal Swabs Contain Less Cellular Material and Are Associated with a Decrease in Gram Stain Smear Quality Compared to Urethral Swabs in Menen_US
dc.typeArticleen_US
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