title: 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.
  
  
  OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Infection Control Committee, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, PR, Brazil; Nursing Department and Post-Graduate Nursing Program, Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: C J N
authors.initials: CJ
authors.lastname: Stier
authors.affiliation: Infection Control Committee, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, PR, Brazil; Nursing Department and Post-Graduate Nursing Program, Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: M C
authors.initials: MC
authors.lastname: Paganini
authors.affiliation: Bacteriology Laboratory, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: H H M
authors.initials: HH
authors.lastname: de Souza
authors.affiliation: Bacteriology Laboratory, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, PR, Brazil; Pequeno Príncipe Faculties, Pequeno Príncipe Pele Research Institute, Curitiba, PR, Brazil.
authors.forename: L M D
authors.initials: LM
authors.lastname: Costa
authors.affiliation: Nursing Department and Post-Graduate Nursing Program, Federal University of Paraná (UFPR), Curitiba, PR, Brazil. Electronic address: souza.s.gabriela@gmail.com.
authors.forename: G S
authors.initials: GS
authors.lastname: dos Santos
authors.affiliation: Nursing Department and Post-Graduate Nursing Program, Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: E D A
authors.initials: ED
authors.lastname: Cruz
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D001431:Bacteriological Techniques / Q000379:methods*; D001938:Brazil; D016022:Case-Control Studies; D016021:Epidemiologic Studies; D062665:Epidemiological Monitoring; D006119:Groin / Q000382:microbiology*; D006801:Humans; D011446:Prospective Studies; D012007:Rectum / Q000382:microbiology*; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*
keywords: Carrier state; Colonization; Drug resistance; Epidemiological surveillance