Sputum culture contamination and associated characteristics in a diagnostic clinical trial, Papua New Guinea.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2024-12-01 DOI:10.5588/pha.24.0029

N D Tenakanai, J K Banamu, Y Lin, D Walsh, R Simbil, M Globan, A Penn-Nicholson, P du Cros, J Greig

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引用次数: 0

Abstract

Setting: Papua New Guinea is a high-burden multidrug-resistant TB (MDR/RR-TB) country that reports low rates of bacteriological confirmation. Sputum drug susceptibility testing for second-line drugs is important. Access to culture is limited.

Objective: To evaluate the prevalence of mycobacterial sputum sample culture contamination and determine factors associated with contamination.

Design: A retrospective analysis of data from a TB diagnostic accuracy study that used culture as the diagnostic reference standard. Data included characteristics of people with presumptive pulmonary TB who provided sputum, sputum quality and culture results.

Results: Sputum (1-3 samples) was collected from 174 adults. The median age was 33 years (IQR 24-47). Of 337 samples sent for culture, 28% were contaminated. Contamination was strongly associated with samples self-collected by participants outside clinic hours (aOR 5.69; 95% CI 2.62-12.38). Contamination risk increased with delays in shipping to the reference laboratory (aOR 1.19 per day, 95% CI 1.10-1.29) beyond the minimum 3 days. Contamination was less frequent among people aged 35-44 years compared to 18-24 years (aOR 0.27, 95% CI 0.10-0.73). Sputum quality was not associated with culture contamination.

Conclusion: Culture contamination could be reduced using spot sputum collection, expedited submission to laboratories and faster shipping when required.

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巴布亚新几内亚一项诊断性临床试验中的痰培养物污染及其相关特征

环境：巴布亚新几内亚是一个高负担的耐多药结核病（MDR/RR-TB）国家，报告的细菌学确证率很低。痰液药敏试验对二线药物很重要。接触文化的机会是有限的。目的：了解痰培养物分枝杆菌污染的流行情况，确定污染的相关因素。设计：对一项使用培养作为诊断参考标准的结核病诊断准确性研究的数据进行回顾性分析。数据包括提供痰的推定肺结核患者的特征、痰质量和培养结果。结果：174例成人共采集痰液1 ~ 3份。中位年龄33岁（IQR 24-47）。在送去培养的337份样本中，28%受到污染。污染与受试者在门诊时间以外自行采集的样本密切相关(aOR 5.69；95% ci 2.62-12.38)。污染风险随着运送到参比实验室的延误（aOR每天1.19,95% CI 1.10-1.29）超过至少3天而增加。与18-24岁人群相比，35-44岁人群的污染发生率较低（aOR 0.27, 95% CI 0.10-0.73）。痰质量与培养污染无关。结论：采用现场采集痰液、加快送检速度、必要时加快运输等方法可减少培养物污染。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.