title: Impact of changing from staining to culture techniques on detection rates of Campylobacter spp. in routine stool samples in Chile.
abstract: BACKGROUND
  Campylobacter is a leading cause of bacterial gastroenteritis, but sensitive diagnostic methods such as culture are expensive and often not available in resource limited settings. Therefore, direct staining techniques have been developed as a practical and economical alternative. We analyzed the impact of replacing Campylobacter staining with culture for routine stool examinations in a private hospital in Chile.
  
  
  METHODS
  From January to April 2014, a total of 750 consecutive stool samples were examined in parallel by Hucker stain and Campylobacter culture. Isolation rates of Campylobacter were determined and the performance of staining was evaluated against culture as the gold standard. Besides, isolation rates of Campylobacter and other enteric pathogens were compared to those of past years.
  
  
  RESULTS
  Campylobacter was isolated by culture in 46 of 750 (6.1 %) stool samples. Direct staining only identified three samples as Campylobacter positive and reached sensitivity and specificity values of 6.5 and 100 %, respectively. In comparison to staining-based detection rates of previous years, we observed a significant increase of Campylobacter cases in our patients.
  
  
  CONCLUSIONS
  Direct staining technique for Campylobacter had a very low sensitivity compared to culture. Staining methods might lead to a high rate of false negative results and an underestimation of the importance of campylobacteriosis. With the inclusion of Campylobacter culture, this pathogen became a leading cause of intestinal infection in our patient population.
authors.affiliation: Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Vitacura 5951, Santiago, Chile. nenapor@gmail.com.
authors.forename: Lorena
authors.initials: L
authors.lastname: Porte
authors.affiliation: Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Vitacura 5951, Santiago, Chile.
authors.forename: Carmen
authors.initials: C
authors.lastname: Varela
authors.affiliation: Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Vitacura 5951, Santiago, Chile.
authors.forename: Thomas
authors.initials: T
authors.lastname: Haecker
authors.affiliation: Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Vitacura 5951, Santiago, Chile.
authors.forename: Sara
authors.initials: S
authors.lastname: Morales
authors.affiliation: Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Av. Vitacura 5951, Santiago, Chile.
authors.forename: Thomas
authors.initials: T
authors.lastname: Weitzel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000379:methods*; D002167:Campylobacter / Q000302:isolation & purification*; D002169:Campylobacter Infections / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D002677:Chile; D004396:Coloring Agents; D005243:Feces / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D055815:Young Adult
chemical_list: D004396:Coloring Agents
keywords: Campylobacter; Culture media; Diagnosis; Staining methods