happymay18
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16-year-old girl is incoherent and has a fever, severe lower abdominal pain, and a foul-smelling cervicovaginal discharge. A self-induced abortion is suspected. Which of the following methods should be used to collect a sample of the cervical discharge for bacterial culture?
A. Inoculating the specimen on mammalian epithelial cells
B. Placing a swab in transport medium at room temperature
C. Taking samples of the discharge with a syringe and transferring them directly into an anaerobic transport medium
D. Using a calibrated inoculating loop to enable direct enumeration of the bacteria in the specimen
answer C
plz expain...
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| akk77
Forum Newbie
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foul smelling is usually anaerobic rite? so it sounds like this pt has an abcess from the self induced abortion, an from wat i know, foul-smelling usually aims toward anaerobic abcesses, like in alcoholics that have lung abcesses from aspirates, those are usually anaerobic as well.. that's just wat i think..
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| bactitech
Forum Elite
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What they want you to say is C. In real life, a cervical culture would not get set up for anaerobes in our laboratory UNLESS it were an aspirate from inside the uterus taken in SURGERY. We never set up cervical specimens for anaerobes, as there are normal anaerobes of the vaginal tract and the specimen would be contaminated with a lot of normal vaginal flora. We also do not work up enterics in vaginal specimens either - we just mention them as "enteric flora." If this were marked on the requisition we would call the floor and TELL them we would not be setting this up for anaerobes.
The trend is going away from vaginal cultures except for vaginal/rectal screens for Group B strep. We just invested in a new instrument that tests for Gardnerella/trichomonas/yeast from a special collection device that tests for the DNA of these organisms. It is called the Affirm. Chlamydia and gonorrhea can be tested by another special collection device that uses DNA amplification as the methodology. I am willing to bet that a few years down the road doctors will no longer send in routine bacterial cultures on the female genital tract. The only thing we work up from them anyway are Group B strep, yeast, GC, and Gardnerella, and the latter is only implicated in bacterial vaginosis - not necessarily the only causative agent for this condition.
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Clinical Microbiology since 1974
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