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Chapter 3.9 : Genital Cultures

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Abstract:

Specimens from genital sites are sent to the clinical microbiology laboratory for detection of microorganisms from females presenting with clinical syndromes such as cervicitis, vulvovaginitis, urethritis, bacterial vaginosis (BV), salpingitis (pelvic inflammatory disease [PID]), endometritis, or genital ulcers and from males exhibiting urethritis, epididymitis, prostatitis, or genital ulcers ( Tables 3.9.1-1 to 3.9.1-3 ) ( ). Specimens are also submitted from pregnant females to diagnose the presence of organisms that may cause disease in the neonate. Less commonly, specimens are sent from children and postmenopausal women ( ).

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Laboratory diagnosis of by culture.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Tables

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Table 3.9.1-1a

Female genital infections that are sexually transmitted

GNB, gram-negative bacillus.

LGV, lymphogranuloma venereum.

Associated with use of intrauterine device.

In wounds, TSS, and tampon-associated ulcerations.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-1b

Female genital infections that are sexually transmitted

GNB, gram-negative bacillus.

LGV, lymphogranuloma venereum.

Associated with use of intrauterine device.

In wounds, TSS, and tampon-associated ulcerations.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-2

Female genital infection clinical syndromes associated with intrapartum, postpartum, and postabortal infections

GNB, gram-negative bacillus.

CT, computed tomography.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-3

Male genital infections

See Table 3.9.1-6 and Appendix 3.9.1-2 .

DFA, direct fluorescent antibody.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-4

Diagnosticcharacteristicsforvaginitisandvaginosis

Data for table extrapolated from Sobel ( ).

A drop of 10% KOH is added to vaginal fluid and sniffed for release of fishy or amine odor.

These tests are for increased sensitivity and might be offered as a panel by laboratory.

Caution: occasional contaminants from the environment, such as while ameboid in motion, may be seen.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-5

Diagnostic tests for combined detection of and

Because of the high rate of dual infection with both and testing for both pathogens should be routinely performed for patients suspected of having either urethritis and/or cervicitis.

Self-collected vaginal swab FDA cleared by some manufacturers for NAT.

If tests for and/or and HSV are negative, BV and should be ruled out. culture or a rapid antigen test or NAT is recommended ( ).

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-6

Specimens collected to diagnose the location of a lower urinary tract infection in men

Data adapted with permission from T. Stamey. 1980. Williams & Wilkins, Baltimore, MD.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Table 3.9.1-7

Biochemical reactions of and other fastidious gram-negative coccobacilli found in genital microbiota

Strains in this table are characterized by no growth on MAC, with the exception of a rare strain. NA, not applicable; V, variable. This table is prepared from biochemical tables from Weyant et al. ( ).

Separate by hemolysis on horse or rabbit blood, if desired; however, and generally are not found in the genital tract.

spp. (DF-1) are rods with tapered ends and frequently have a yellow pigment; DF-3 is a coccobacillus. They both may hydrolyze esculin.

Not generally a pathogen but mimics it will grow on BAP, is nitrate positive, and is a coccobacillus.

The nitrate reaction is first; if the gas reaction is known, it is listed second, preceded by a slash.

May not be able to demonstrate reactions without addition of rabbit serum, if organism is fastidious.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
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Untitled

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
Generic image for table
Untitled

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
Generic image for table
Table 3.9.3-1

Biochemical reactions of and related oxidase-positive diplococci and rods that may grow on Thayer-Martin or similar selective agar

Abbreviations: PRO, prolyl-iminopeptidase; BGAL, β-galactosidase: GLUT, δ-glutamyl-aminopeptidase; V, variable reactions; + −, reaction is generally positive, but rare negative results occur, resulting in critical misidentifications if other tests are not also performed; R, resistant; S, susceptible. Polymyxin B can be substituted for colistin, or susceptibility can usually be determined by growth or lack of growth on Thayer-Martin or other selective agar with colistin or polymyxin B. Reactions are from package inserts, from http://www.CDC.gov/ncidod/dastlr/gcdir/neident/index.html, and from references and .

This organism(s) does not usually grow on selective media for and colonies are yellow; is the only species other than to be GLUTpositive.

Nutrient agar, MH agar, or TSA without blood at 35°C.

See procedure 3.17.7. Do not read after time period in package insert, as this delay may result in false-positive reactions. Many spp. and spp. are butyrate positive. Isolatemust be a diplococcus for identification of to be accurate.

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9
Generic image for table
Untitled

Citation: Garcia L. 2010. Genital Cultures, p 269-311. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch3.9

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