title: Comparison of rectal swabs with fecal cultures for detection of Salmonella typhimurium in adult volunteers.
abstract: Rectal swabs are generally considered less sensitive than fecal culture, but there are no data directly comparing human rectal swabs with fecal samples for detection of Salmonella. A phase I clinical study of a live oral attenuated Salmonella typhimurium vaccine strain in volunteers receiving a large known inoculum provided the opportunity to compare concurrent rectal swab and fecal cultures. Of 155 paired samples from 9 volunteers, 65 (42%) were culture positive: 35 (54%) by both methods, 20 (31%) by fecal culture only, and 10 (15%) by swab only. When compared with fecal culture, rectal swabs were 64% sensitive and 90% specific. Rectal swabs are of moderate diagnostic utility for detection of Salmonella and may be useful when collection of fecal samples is impractical.
authors.affiliation: Infectious Disease Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. ckotton@partners.org
authors.forename: Camille N
authors.initials: CN
authors.lastname: Kotton
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Lankowski
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Hohmann
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques; D005243:Feces / Q000382:microbiology*; D006801:Humans; D012007:Rectum / Q000382:microbiology*; D012480:Salmonella Infections / Q000175:diagnosis* / Q000382:microbiology* / Q000517:prevention & control; D022562:Salmonella Vaccines / Q000276:immunology; D012486:Salmonella typhimurium / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D013048:Specimen Handling
chemical_list: D022562:Salmonella Vaccines