Swab Results Research Articles

Gender specific differences in urethral swabs: a retrospective single-center analysis.

Sexually transmitted infections (STIs) are globally on the rise yet accurate data regarding infection rates remains scarce. There is the assumption that STIs among women with chronic urinary tract infections (UTIs) have been underestimated. This may arise from the reliance on specialised cultivation or Nucleic Acid Amplification Techniques (NAT) for detection, which are more costly than standard urine culture and are typically only conducted by specialists like urologists. A retrospective, observational, single-centre study using medicals records of patients who received a urethral swab in a German urological practice in the past five years has been conducted. 55% had a STI requiring treatment. People with recurrent UTI had a STI in 35% of the casees. Younger age is associated with the detection of STI. The female gender is significantly associated with a positive swab result. Distinguishing between cystitis and urethritis, particularly in women with recurrent UTIs experiencing dysuria, presents a clinical challenge. The prevalence of asymptomatic infections suggests that the true burden of urethritis, particularly STIs, may be substantially higher in the general population. This underscores the urgency of establishing guidelines for referral and diagnostic evaluation, as delayed or inadequate treatment may contribute to escalating infection rates and antibiotic resistance.

Do vaginal swabs alter empirical clinical management in obstetrics and gynaecology: A retrospective case-series and activity-based costing of the vaginal swab.

Vaginal swab microbiological testing is commonly performed as routine clinical management for various obstetric and gynaecological presentations. The clinical utility and cost-effectiveness of vaginal swab microscopy, culture and susceptibilities (MCS) in altering empirical management is ill-defined. To describe the clinical use of vaginal swabs in a tertiary women's hospital emergency department (ED), measure the impact of vaginal swabs on altering empirical clinical management, and to determine the economic cost of vaginal swab MCS. Retrospective case-series of vaginal swabs collected at a single, tertiary women's ED between January 2021 and July 2021. Symptomatology, clinical diagnosis, test results, and pre-swab and post-swab clinical management were determined upon medical record review. Economic costs of vaginal swab MCS were retrospectively determined via internal accounting records, permitting unit-level activity-based costing. A total of 660 vaginal swabs from 584 clinical episodes were included. Vulvovaginitis was the most common indication for swab collection (34.5%, 167 samples). Altered empirical management was observed in 9.8% of all swabs (95% CI 7.4-12.2%), with marked variability between clinical indications. Antimicrobial initiation was the most common alteration in management (8.9%, 95% CI 8.7-9.1%). The estimated cost of vaginal swab MCS was $29.71 AUD; labour, consumables and disposal costs accounted for 69.3, 29.8 and 0.9%, respectively. The impact of vaginal swab MCS on empirical clinical management is context-specific and variable. The majority of swabs performed do not impact upon empirical management. Antimicrobial initiation is appreciably more common than antimicrobial cessation with vaginal swab results.

Detection of Mycoplasma sp using next-generation DNA sequencing is common on nasal swabs from both healthy and unhealthy pet rabbits (Oryctolagus cuniculus).

Upper respiratory infections are a frequent problem in pet rabbits and rodents, and Mycoplasma pulmonis is 1 of the most common causes of respiratory infections in pet rats. M pulmonis was detected in 1967 in laboratory rabbits via culture of the nares and oropharynx, but overall, Mycoplasma is not commonly identified in the upper airway of rabbits. The objective of this study was to compare the prevalence of Mycoplasma sp detection via next-generation DNA sequencing on nasal swabs obtained from healthy and unhealthy rabbits. The results of nasal swabs from both healthy and unhealthy rabbits submitted for next-generation DNA sequencing from January 2022 to February 2023 were reviewed. Data gathered included signalment, whether or not Mycoplasma sp was detected, and the cell count and relative predominance of Mycoplasma sp compared to other organisms. 91 rabbits met the inclusion criteria, of which 49 were healthy and 42 were unhealthy. Overall, 52 of 91 (57.1%) rabbits were positive and 39 of 91 (42.8%) were negative for Mycoplasma sp. Mycoplasma positivity was significantly (P < .001) more common in healthy rabbits (37/49 [75.5%]) compared to unhealthy rabbits (15/42 [35.7%]). The fact that Mycoplasma positivity was common in both groups of rabbits, and particularly common in rabbits without upper respiratory signs, suggests that Mycoplasma may be normal nasal flora in rabbits. Further research is needed to determine whether Mycoplasma could function as an opportunistic pathogen in rabbits.

Rapid de-escalation of anti-MRSA therapy guided by S. aureus nares screening for patients with pneumonia: protocol of a randomized controlled trial (SNAP study).

The current Infectious Disease Society of America and American Thoracic Society (IDSA/ATS) guidelines recommend linezolid or vancomycin as an empiric treatment for methicillin-resistant Staphylococcus aureus (MRSA) pneumonia in hospitalized patients with specific risk factors,. A nasal PCR-assay for MRSA, with its high negative predictive value, can guide a rapid antibiotic de-escalation avoiding unnecessary anti-MRSA treatment. The indiscriminate use of these drugs has contributed to the emergence of resistant S. aureus strains leading to adverse effects without any survival benefit, increasing hospital stays and associated costs. Aim of the study is the use of this diagnostic tool to reduce empirical anti-MRSA treatment duration in pneumonia, shortening antimicrobial therapy days while measuring in-hospital mortality, length of stay and adverse drug event incidence. It is a prospective, randomized single-center controlled trial planned to be conducted in the Azienda Consorziale Policlinico di Bari. The research project will have a duration of 12 months following the approval of the Ethical Committee of the University of Bari. The minimum sample size is 38 patients per group, for a total of 76 subjects, calculated assuming a standard deviation of 10, a power of 90%, a type I error of 5% and a 10% drop-out rate. We will enroll eligible patients ensuring their evidence-based management according to guidelines, we will perform a nasal swab for MRSA in patients in the experimental group and discontinue the empirical anti-MRSA therapy if the nasal swab result is negative. For both arms, follow-up visits will be on day 2, 5, 7, 14, and 28 relatives to the enrollment visit (day 0). Data will be collected on the clinical course of pneumonia and laboratory tests. Our study will provide evidence on the duration (in days) of the antibiotic intake as a primary outcome of the study. Secondary outcome measures include in-hospital mortality, the length of stay and days of mechanical ventilation (in VAP), and the incidence of adverse events related to the administration of the therapy. https://classic.clinicaltrials.gov/ct2/show/NCT06238297, identifier NCT06238297.

Clinical characteristics and viral colonization of corneal donors with coronavirus disease 2019: a comprehensive analysis before and after corneal transplantation

Purpose To evaluate the clinical characteristics and viral Colonization of corneas donated by volunteers with coronavirus disease 2019 (COVID-19) before and after corneal transplantation. Methods We retrospectively compared the characteristics and clinical outcomes of patients who received corneas from donors with and without a history of COVID-19 after corneal transplantation. Reverse transcription-polymerase chain reaction (RT-PCR) was performed to evaluate the expression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA on ocular surfaces in corneal preservation solutions as well as the recipients’ tears. Immunofluorescence was also performed to evaluate the expression of viral spike proteins in the corneas. Intraocular pressure (IOP) measurement, optical coherence tomography (OCT), and slit-lamp inspection at each follow-up examination were performed to assess the surgical efficacy. Results The RT-PCR results of eye surface swabs before corneal extraction, the corneal preservation solutions before transplantation as well as the recipients’ tears were negative, thereby indicating the suitability for transplantation. No significant differences in IOP measurements, OCT findings, or in the incidence of post transplantation complications were observed between donors with and without COVID-19. Conclusions Corneal transplantation using corneas from COVID-19 infected donors does not alter clinical outcomes when compared to controls receiving corneas from non-infected donors.

Interleukin-6 and Interleukin-10 as a Predictor of Mortality in Elderly with COVID-19.

The age group at the most high risk for mortality due to SARS-CoV-2 infection was the elderly. This study aims to analyze markers that can predict the severity and mortality of elderly COVID-19 patients. This study used a cohort retrospective design. We include adult and elderly COVID-19 patients at Universitas Airlangga Hospital from March to August 2021. The sample used was 48 COVID-19 patients with positive real-time polymerase chain reaction swab results. We check the complete blood count and serum levels of interleukin-6 (IL-6) and IL-10 using enzyme-linked immunosorbent assay during admission. Data were analyzed using t -test, Mann-Whitney, Chi-square, Pearson, and Kendall Tau correlation. Leukocyte level (6.6 ± 2.5) was lowest in the severe-critical elderly group. Neutrophil level (75.3 ± 10.2) was highest in the mild-moderate elderly group. Lymphocyte level (18.8 ± 8.7) was highest in mild-moderate nonelderly group. Platelet level (279.0 ± 117.7) was highest in the mild-moderate elderly group. Neutrophil to lymphocyte ratio level (9.1 ± 9.4) was highest in the severe-critical nonelderly group, IL-6 level (98.6 ± 144.1) was highest in the severe-critical elderly group, IL-10 level (107.7 ± 47.7) was highest in the severe-critical elderly group and highest IL-6/IL-10 level (1.4 ± 1.7) was found in the mild-moderate elderly group no significant differences in biomarkers identification between the elderly and nonelderly groups. There was a substantial relationship between IL-10 levels and gender, IL-10 level, and hospital discharge condition. Female elderly patients and alive elderly patients were correlated with increased levels of IL-10.

Evaluating diagnostic accuracy of an RT-PCR test for the detection of SARS-CoV-2 in saliva

Background and objectiveSaliva has been proposed as a potential more convenient, cost-effective, and easier sample for diagnosing SARS-CoV-2 infections, but there is limited knowledge of the impact of saliva volumes and stages of infection on its sensitivity and specificity.MethodsIn this study, we assessed the performance of SARS-CoV-2 testing in 171 saliva samples from 52 mostly mildly symptomatic patients (aged 18 to 70 years) with a positive reference standard result at screening. The samples were collected at different volumes (50, 100, 300, and 500 µl of saliva) and at different stages of the disease (at enrollment, day 7, 14, and 28 post SARS-CoV-2 diagnosis). Imperfect nasopharyngeal (NP) swab nucleic acid amplification testing was used as a reference. We used a logistic regression with generalized estimating equations to estimate sensitivity, specificity, PPV, and NPV, accounting for the correlation between repeated observations.ResultsThe sensitivity and specificity values were consistent across saliva volumes. The sensitivity of saliva samples ranged from 70.2% (95% CI, 49.3–85.0%) for 100 μl to 81.0% (95% CI, 51.9–94.4%) for 300 μl of saliva collected. The specificity values ranged between 75.8% (95% CI, 55.0–88.9%) for 50 μl and 78.8% (95% CI, 63.2–88.9%) for 100 μl saliva compared to NP swab samples. The overall percentage of positive results in NP swabs and saliva specimens remained comparable throughout the study visits. We observed no significant difference in cycle number values between saliva and NP swab specimens, irrespective of saliva volume tested.ConclusionsThe saliva collection offers a promising approach for population-based testing.

Relative Contribution of Diagnostic Testing to the Diagnosis of Respiratory Syncytial Virus in Hospitalized Adults in the United States.

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory illness (ARI) in older adults. Optimizing diagnosis could improve understanding of RSV burden. We enrolled adults ≥50 years of age hospitalized with ARI and adults of any age hospitalized with congestive heart failure or chronic obstructive pulmonary disease exacerbations at two hospitals during two respiratory seasons (2018-2020). We collected nasopharyngeal (NP) and oropharyngeal (OP) swabs (n=1558), acute and convalescent sera (n=568), and expectorated sputum (n=153) from participants, and recorded standard-of-care (SOC) NP results (n=805). We measured RSV antibodies by two immunoassays and performed BioFire testing on respiratory specimens. Of 1,558 eligible participants, 92 (5.9%) tested positive for RSV by any diagnostic method. Combined NP/OP PCR yielded 58 positives, while separate NP and OP testing identified 11 additional positives (18.9% increase). Compared to Study NP/OP PCR alone, the addition of paired serology increased RSV detection by 42.9% (28 vs 40) among those with both specimen types, while the addition of SOC swab RT-PCR results increased RSV detection by 25.9% (47 vs 59). The addition of paired serology testing, SOC swab results, and separate testing of NP and OP swabs improved RSV diagnostic yield in hospitalized adults.

Impact of Stewardship Pharmacist Driven MRSA Nasal Surveillance and De-escalation of Anti-MRSA Therapy

Background: Intravenous vancomycin is commonly used as initial empiric coverage for pneumonia but is often unnecessary. MRSA nasal surveillance cultures (MRSA nasal swab) have been highlighted in recent literature and the 2019 IDSA Pneumonia Treatment Guidelines as a tool to avoid unnecessary MRSA coverage in pneumonia. A negative MRSA nasal swab can be utilized by clinicians to de-escalate anti-MRSA therapies for pneumonia. The purpose of this study is to determine if implementing stewardship pharmacist driven MRSA nasal surveillance increases use of the test and reduces the inappropriate use of vancomycin for MRSA coverage in patients with pneumonia. Method: This study was a retrospective chart review and was approved by the Trinity Health of New England Institutional Review Board. For this initiative, a stewardship pharmacist evaluated all patients receiving vancomycin for anti-MRSA therapy at Saint Francis Hospital and Medical Center in Hartford, CT. If the patient’s indication was pneumonia and a MRSA nasal swab had not been ordered, the pharmacist contacted the patient’s provider and requested an order for it. Upon receipt of a negative MRSA nasal swab result, the pharmacist recommended discontinuation of vancomycin to the provider if appropriate. Outcomes from the first four weeks of the pharmacist-driven initiative (April 10, 2023 to May 5, 2023) were compared to the four weeks prior to the initiative (March 13, 2023 to April 7, 2023) as a control group. The primary outcome of this study was percentage of patients who received a MRSA nasal swab. Secondary outcomes included percentage of patients who had vancomycin appropriately de-escalated based on MRSA nasal swab results and mean length of vancomycin therapy. Result: 116 patients met inclusion criteria: 61 in the control group and 55 in the intervention group. Percentage of swabs ordered increased from 36.1% (22/61) without pharmacist intervention to 80.0% (44/55) with pharmacist intervention (p &lt; 0 .0001). There were also increased rates of vancomycin de-escalation in patients with pharmacist intervention, with 58.2% (32/55) of patients in the intervention group having vancomycin discontinued following a negative MRSA swab compared to 19.7% (12/61) in the control group (p &lt; 0 .0001). Conclusion: The results suggest implementing a pharmacist driven MRSA nasal surveillance program into practice could increase the number of MRSA nasal swabs ordered and in turn promote more timely de-escalation of vancomycin in patients with pneumonia. The results from this study can be used to support the wide-spread use of pharmacist driven MRSA nasal surveillance protocols at other institutions.

Early initiation of combined therapy in severely immunocompromised patients with COVID-19: a retrospective cohort study

This single-centre retrospective cohort study reports on the results of a descriptive (non-comparative) retrospective cohort study of early initiation of antivirals and combined monoclonal antibody therapy (mAbs) in 48 severely immunocompromised patients with COVID-19. The study assessed the outcomes and the duration of viral shedding. The patients started early combined therapy (ECT) a median of 2 days (interquartile range [IQR]: 1–3 days) after the diagnosis of SARS-CoV-2 infection. Except for 1 patient who died due COVID-19-related respiratory failure, patients had their first negative nasopharyngeal swab result after a median of 11 days (IQR: 6–17 days) after starting combined therapy. There were no reports of severe side effects. During a follow-up period of 512 days (interquartile range [IQR]: 413–575 days), 6 patients (12.5%) died and 16 (33.3%) were admitted to hospital. Moreover, 12 patients (25%) were diagnosed with SARS-CoV-2 reinfection a median of 245 days (IQR: 138–401 days) after starting combined treatment. No relapses were reported. Although there was no comparison group, these results compare favourably with the outcomes of severely immunocompromised patients with COVID-19 reported in the literature.

A novel easy-to-desorb eluant contributes to address environmental contamination of African swine fever virus

African swine fever virus (ASFV) is a highly pathogenic and rapidly disseminated virus with strong viability in the environment, suggesting the importance of environmental detection for prevention and control in all the pig industry. However, the detection results of environmental swabs cannot always reflect the accurate status of viral pollution, leading to persistent ASFV environmental contamination. In this study, we developed an ASFV eluant with higher environmental ASFV detection efficiency relative to 0.85% saline solution, which obtains the patent certificate issued by the China Intellectual Property Office (patent number:202010976050.9). qPCR analysis showed that in the environmental swab samples, the number of viral copies was 100 times higher for the ASFV eluant treatment than the traditional eluant treatment (0.85% saline solution). And besides, the high sensitivity of the ASFV eluant had be verified in a slaughterhouse environmental sampling detection. In soil samples, the ASFV eluent showed the same extraction effect as the TIANamp Soil DNA Kit, in contrast to no extraction effect for 0.85% saline solution. Simultaneously, this eluent could protect ASFV from degradation and allow the transportation of samples at ambient temperature without refrigeration. In clinical practice, we monitored the environmental contamination condition of the ASFV in a large-scale pig farm. The results shown that the ASFV load decreased after every disinfection in environment. This study provides an effective solution for surveilling the potential threat of ASFV in environment.

Genome Monitoring of SARS-CoV-2 Circulating in the Kyrgyz Republic in 2020–2021

Introduction: The RNA-containing severe acute respiratory syndrome virus SARS-CoV-2 has spread rapidly around the world by adaptation to the host through genetic evolution. The emergence of variants with genetic mutations that increase contagiousness and transmission may hamper the effectiveness of disease control programs and efficacy of vaccination. Objective: To establish dominant SARS-CoV-2 variants circulating in the Kyrgyz Republic in 2020–2021. Materials and methods: Genomic monitoring was carried out based on positive results of testing nasopharyngeal swabs. SARS-CoV-2 was detected by a real-time reverse transcription –polymerase chain reaction (RT-PCR) assay using registered commercial test kits. Genetic variants (n = 15) were determined by high-throughput sequencing on a MiSeq device (Illumina, USA) using the COVID-19 ARTIC v3 protocol. Mutational variability of SARS-CoV-2 was examined using a cluster analysis of amino acid substitutions in the S protein using Ward’s method. Nucleotide sequences from Kyrgyzstan (n = 15), Russia (n = 16), India (n = 2), and China (n = 2) were aligned using MAFFT. IQ-TREE v1.6.12 was used to infer the phylogenetic tree by maximum likelihood applying Nextstrain processes. Isolates Wuhan/Hu-1/2019 and Wuhan/WH01/2019 downloaded from the GenBank® database were considered to be the root of the tree (reference). Results: Phylogenetic data analysis revealed that SARS-CoV-2 B.1.1.7 (Alpha) was the dominant VOC variant, the proportion of which was as high as 36.4 % (12/33); B.1.351 (Beta) was also found (6.1 % or 2/33). When samples were examined for amino acid substitutions in the S-protein, B.1.1.7 Alpha (British) isolates were found to cluster into two distinct branches. Conclusion: The study of the frequency and influence of mutations on pathogenetic properties of the virus, as well as the analysis of the predominant variants of the virus will allow timely measures to be taken to counteract the spread of SARS-CoV-2 in the country. In this regard, continuous genome monitoring of circulating COVID-19 variants is necessary.

Analytical and clinical validation of a multiplex PCR assay for detection of Neisseria gonorrhoeae and Chlamydia trachomatis including simultaneous LGV serotyping on an automated high-throughput PCR system.

For effective infection control measures for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), a reliable tool for screening and diagnosis is essential. Here, we aimed to establish and validate a multiplex PCR assay on an automated system using a dual-target approach for the detection of CT/NG and differentiation between lymphogranuloma venereum (LGV) and non-LGV from genital and extra-genital specimens. Published primer/probe sets (CT: pmpH, cryptic plasmid; NG: porA, opa) were modified for the cobas 5800/6800/8800. Standards quantified by digital PCR were used to determine linearity and lower limit of detection (LLoD; eSwab, urine). For clinical validation, prospective samples (n = 319) were compared with a CE-marked in vitro diagnostics (CE-IVD) assay. LLoDs ranged from 21.8 to 244 digital copies (dcp)/mL and 10.8 to 277 dcp/mL in swab and urine, respectively. A simple linear regression analysis yielded slopes ranging from -4.338 to -2.834 and Pearson correlation coefficients from 0.956 to 0.994. Inter- and intra-run variability was <0.5 and <1 cycle threshold (ct), respectively. No cross-reactivity was observed (n = 42). Clinical validation showed a sensitivity of 94.74% (95% confidence interval (CI): 87.23%-97.93%) and 95.51% (95% CI: 89.01%-98.24%), a specificity of 99.59% (95% CI: 97.71%-99.98%) and 99.57% (95% CI: 97.58%-99.98%), positive predictive values of 89.91% (estimated prevalence: 3.7%; 95% CI: 80.91%-95.6%) and 88.61% (estimated prevalence: 3.4%; 95% CI: 80.18%-94.34%), and negative predictive values of 99.81% (95% CI: 98.14%-100%) and 99.85% (95% CI: 98.14%-100%) for the detection of CT and NG, respectively. In conclusion, we established a dual-target, internally controlled PCR on an automated system for the detectiwon of CT/NG from genital and extra-genital specimens. Depending on local regulations, the assay can be used as a screening or a confirmatory/typing assay.IMPORTANCEChlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) represent a major global health burden, with the World Health Organization estimating that >128 million and >82 million people, respectively, were newly infected in 2020. For effective infection control measures, a reliable tool for sensitive diagnosis and screening of CT/NG is essential. We established a multiplex PCR assay for the detection of CT/NG and simultaneous discrimination between lymphogranuloma venereum (LGV) and non-LGV strains, which has been validated for genital and extra-genital specimens on a fully automated system. To increase assay sensitivity, a dual-target approach has been chosen for both pathogens. This strategy reduces false-positive results in oropharyngeal swabs due to the detection of commensal N. species that may harbor NG DNA fragments targeted in the PCR due to horizontal gene transmission following previous infection. In sum, the established assay provides a powerful tool for use as either a screening/diagnostic or a typing/confirmatory assay.

Bacitracin agar vs. oleandomycin disk supplemented chocolate agar for the recovery of Haemophilus influenzae in diagnostic samples: A prospective comparison

Haemophilus influenzae is an important pathogen able to cause various forms of respiratory and invasive disease. To provide high sensitivity for detection, culture media must inhibit growth of residential flora from the respiratory tract. This study aimed to identify and compare the diagnostic and economic advantages of using bacitracin containing selective agar (SEL) or oleandomycin disk supplemented chocolate agar (CHOC). Growth and semi-quantitative abundance of H. influenzae and growth suppression of residential flora was prospectively assessed in a 28-week period.H. influenzae was identified in 164 (5 %) of all included samples: CHOC and SEL, CHOC only, and SEL only were positive in 95, 24, and 45 cases. Diagnostic superiority of SEL was primarily attributable to the results of throat swabs. However, on average, € 200 had to be spent for the detection of each additional isolate that was recovered only because of additional incubation on SEL.

TREATMENT OF BABESIOSIS AND ECTOPARASITIC INFESTATION IN TERRIER CROSSBREED DOG

Babesiosis is an infectious disease caused by Babesia sp. distributed in the circulatory system. A 5-month-old male Terrier mix with a body weight of 6.20 kg had complaints of weakness and many ticks all over the dog's body. The results of the physical examination found ticks almost all over the body, pale eye mucosa, erythema on the right ear, and the inside of the ear was dirty. Laboratory examination results include routine haematological examination showing hypochromic normocytic anaemia followed by leucocytosis and lymphocytosis; blood smear examination showing Babesia sp erythoparasites; microscopic examination found Rhipicephalus sanguineus ticks and Ctenocephalides canis larvae on the skin and nails of dogs and the results of earwax swabs found Otodectes cynotis. Based on the results of history taking, physical examination, and laboratory examination, the case dog was diagnosed with babesiosis with a prognosis of fausta. The therapy given was imidocarb dipropionate 6.6mg/kg BW every 2 weeks for 3 repetitions; doxycycline 10 mg/kg BW twice a day for 21 days; and ivermectin 0.2 mg/kg BW given once a week for 3 repetitions; and herbal oabat Fufang E'jiao Jiang 1 ml/kg given once a day for 7 days. Observation on the 14th day of therapy showed clinical improvement such as lethargy that disappeared, decreased intensity of nausea, and reduced tick infestation.

Lanyard Cards and Mobile Phones: Vectors for Transmission of Infection at New Najran General Hospital, Saudi Arabia? A cross-Sectional Observation Study with Epidemiological Analysis

Background: Nosocomial infections represent one of the challenging problems of the modern medicine. Healthcare providers play an important role in the transmission of these infections. We aimed to determine the extent of colonization of identity (ID) tags worn around the necks of healthcare workers, and mobile phones and to describe the organisms isolated from them. Subjects and Methods: This cross-sectional study was conducted on 69 hospital staff volunteers. Data were collected on job location, description base and the age of the lanyard and the time. The sample were collected from Staff who were wearing fabric or metal-bead ID card lanyards in a range of intensive care unit (ICU), wards and non-clinical areas. Results: On basis of the working place, nurses showed higher tag-cleaning frequency, followed by doctors (37.5%, 20.7%, respectively), while technicians never cleaned their tags. Doctors showed higher frequency of hand hygiene/day followed by nurses (6.07 ± 2.4, 5.81 ± 2.3 respectively). Tag swab results revealed higher growth of Coagulase-negative staphylococci among doctors (51.7%) and Alpha-hemolytic streptococci were detected only among nurses (6.3%). Mobile swab results revealed higher growth of Coagulase-negative staphylococci among doctors and technicians (58.6%, 50% respectively). Conclusions: ID tags and mobiles are potential sources of pathogen spread so many efforts should be taken to make staff awareness toward the potential danger in every institution.

Value of the Rapid Immunochromatographic Test for Diagnostic Guidance in the Diagnosis of Pharyngo-Tonsillitis Caused by Group A Hemolytic Beta Streptococcus (Abhs) In Southern Benin

Background: Group A beta-hemolytic streptococcus (ABHS) tonsillitis is an acute disease that is often benign but sometimes serious due to its locoregional and general complications. It is a frequent cause of consultation among general practitioners, ENT and paediatrics. The choice and interest of our work was motivated by the fact that one of the most important acute upper respiratory infections is tonsillitis with the risk of serious complications. This study aims to determine the sensitivity and specificity of RDOT in the diagnosis of ABHA tonsillitis in southern Benin. Methods: This was a prospective analytical and descriptive study carried out at the Vallée de Grâce Medical Clinic (CM VG) and at the Padre Pio Humanitarian Health Center (CSVH), at the Laboratory of Biology and Molecular Typing in Microbiology / UAC, in Benin over 12 months (July 2, 2022 and June 31, 2023). It included patients diagnosed with tonsillitis. All the patients included underwent a RDOT and a cytobacteriological examination of the throat swab (Gold Standard). We studied the following variables: age, sex, months, clinical signs, cytobacteriological examination of the throat swab and TROD results. Results: We recorded 272 tonsillitis cases. 60 cases of group A beta-hemolytic streptococcal (ABHS) tonsillitis are confirmed by bacterial culture. Group A beta-hemolytic streptococcal tonsillitis accounted for 22.06% of tonsillitis. 133 men (49%) and 139 women (51%) were registered. 32 men (53.33%) and 28 women (46.67%) had SBHA tonsillitis. The highest frequency of isolation of group A streptococcus was observed in the age group [0 to 5[years with 27 cases out of 60, i.e. a proportion of 45%. SBHA tonsillitis are more frequent in the months of December and August with the respective proportions of 16.67% and 10%. The SBHA TROD performed showed a Sensitivity of 95%, a Specificity of 94%, a positive predictive value of 92% and a negative predictive value of 98%. Conclusion: Streptococcal etiology represents 22.06% of tonsillitis in Benin. Our results reinforce the interest of RDOT and especially cytobacteriological examination in the etiological diagnosis of tonsillitis.

Embedding a Novel Screening Programme for Sexually Transmitted Infections Within an Ambulatory Emergency Surgical Admissions Unit: An Observational Cohort Study

Abstract Aims To establish a sexually transmitted infection (STI) screening programme for females presenting to an Emergency Ambulatory Surgical Clinic (ASC), and to analyse incidence and prevalence of STIs as an underlying cause for their abdominal pain. Methods Observational cohort study in ASC of a tertiary hospital. Between December 2021 to December 2022, females aged 18-44 years presenting with abdominal pain were offered self-collected vulvovaginal swabs for chlamydia and gonorrhoea as part of a new standardised diagnostic pathway. Positive results were referred to local sexual health services for treatment and contact tracing. Main outcome measures included number of patients consenting to the screening programme and number of positive swab results. Results The cohort comprised 297 eligible patients; 259 with 20 patients declining testing and 18 samples rejected. A total of 5.4% of swabs were positive (2 gonorrhoea, 12 chlamydia) with mean age of 24.5. All positive patients presented with lower abdominal pain and of these, only 25% had a documented sexual history during assessment. 7 had further imaging with 4 results diagnosing pelvic inflammatory disease (PID). 4 patients were treated for PID empirically. Remaining patients were treated for non-specific pain or unrelated pathology. Conclusions Undiagnosed STIs are prevalent, and have known fertility and public health risks. Young females with lower abdominal pain provide an opportunistic and arguably necessary screening cohort in ASC with good uptake of self-testing. Results demonstrate high incidence of positive tests, suggesting that inclusion of sexual history during assessment is vital to identify those with highest STI risk.

691. Association between Clostridioides difficile Colonization, Rectal Swab NAAT Positivity, and Environmental Contamination

Abstract Background Clostridioides difficile (CD) colonization is common among hospitalized patients. Screening for toxigenic CD (TCD) colonization with rectal swab nucleic acid amplification tests (NAAT) may identify people at risk for CDI and help prevent onward TCD transmission, especially in immunocompromised patients with long hospitalizations. The study objective was to test whether rectal swab NAAT could detect TCD colonized patients and whether NAAT results identify patients that contribute to environmental contamination. Methods This was a prospective cohort study on two BMT/Leukemia units. Stool specimens, rectal swabs, and environmental swabs (bedrail, room sink, keyboard) were collected from patients at admission and weekly and cultured semi-quantitatively for TCD. NAAT (Cepheid) was performed on rectal swabs (eSwabs; Copan Diagnostics). The relationship between stool TCD concentration, NAAT Ct, and a positive environmental culture was evaluated using univariate logistic regression. Bleach was used for daily and terminal discharge cleaning of all rooms. Toxigenicity was determined by detection of tcdA or tcdB by whole genome sequencing (WGS). Results From January 2019 - July 2019, 659 stool specimens and 495 rectal swabs were collected from 384 patients. Specimens from 554 patient-days were cultured and 126 (23%) were positive. Of those, 88 (70%) were TCD. 21 of 987 (2%) environmental swabs were TCD positive; 18 (86%) were from bedrails. Among 61 unique patient calendar days with paired rectal swab NAAT and stool culture results (paired samples), overall sensitivity of rectal swab NAAT to detect toxigenic CD colonization compared to culture was 44%, with 4/16 (25%) of people colonized with &amp;gt; 0 - &amp;lt; 10,000 CFU/g of TCD and 7/9 (78%) with ≥ 10,000 CFU/g TCD (Figure 1). There was no relationship between stool culture or rectal swab NAAT result and risk of a positive environmental swab (Figure 2). Figure 1. Toxigenic C. difficile semi-quantitative culture and rectal swab NAAT on paired patient-day of specimen collection (N=61 patient-days) Figure 2. Toxigenic C. difficile semi-quantitative stool and rectal swab NAAT results and environmental contamination by paired patient-day of specimen collection Conclusion Rectal swab NAAT may not be sufficiently sensitive to screen for TCD colonization that contributes to environmental contamination. Disclosures Erik R. Dubberke, MD, MSPH, Abbott: Advisor/Consultant|AstraZeneca: Advisor/Consultant|Ferring Pharmaceuticals: Advisor/Consultant|Ferring Pharmaceuticals: Grant/Research Support|Merck and Co.: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Seres Therapeutics: Advisor/Consultant|Summit: Advisor/Consultant|Theriva Biologics: Grant/Research Support

930. COVID-19 symptom and viral load rebound among individuals reporting nirmatrelvir/ritonavir use compared to propensity score matched individuals not taking COVID-19 treatment

930. COVID-19 symptom and viral load rebound among individuals reporting nirmatrelvir/ritonavir use compared to propensity score matched individuals not taking COVID-19 treatment