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Multisite direct determination of the potential for environmental contamination of urine samples used for diagnosis of sexually transmitted infections

Andersson, Patiyan, Tong, Steven Y. C., Lilliebridge, Rachael A., Brenner, Nicole C., Martin, Louise M., Spencer, Emma, Delima, Jennifer, Singh, Gurmeet, McCann, Frances, Hudson, Carolyn, Johns, Tracy and Giffard, Philip M. (2014). Multisite direct determination of the potential for environmental contamination of urine samples used for diagnosis of sexually transmitted infections. Journal of the Pediatric Infectious Diseases Society,3(3):189-196.

Document type: Journal Article

IRMA ID cmartelxPUB171
Title Multisite direct determination of the potential for environmental contamination of urine samples used for diagnosis of sexually transmitted infections
Author Andersson, Patiyan
Tong, Steven Y. C.
Lilliebridge, Rachael A.
Brenner, Nicole C.
Martin, Louise M.
Spencer, Emma
Delima, Jennifer
Singh, Gurmeet
McCann, Frances
Hudson, Carolyn
Johns, Tracy
Giffard, Philip M.
Journal Name Journal of the Pediatric Infectious Diseases Society
Publication Date 2014
Volume Number 3
Issue Number 3
ISSN 2048-7193   (check CDU catalogue open catalogue search in new window)
Start Page 189
End Page 196
Total Pages 8
Place of Publication United Kingdom
Publisher Oxford University Press
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
The detection of a sexually transmitted infection (STI) agent in a urine specimen from a young child is regarded as an indicator of sexual contact. False positives may conceivably arise from the transfer of environmental contaminants in clinic toilet or bathroom facilities into urine specimens.

Methods
The potential for contamination of urine specimens with environmental STI nucleic acid was tested empirically in the male and female toilets or bathrooms at 10 Northern Territory (Australia) clinics, on 7 separate occasions at each. At each of the 140 experiments, environmental contamination with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis nucleic acid contamination was determined by swabbing 10 locations, and urine collection was simulated 5 times, using a (1) synthetic urine surrogate and (2) a standardized finger contamination procedure.

Results
The most contaminated toilets and bathrooms were in remote Indigenous communities. No contamination was found in the Northern Territory Government Sexual Assault Referral Centre clinics, and intermediate levels of contamination were found in sexual health clinics and in clinics in regional urban centres. The frequency of surrogate urine sample contamination was low but non-zero. For example, 4 of 558 of the urine surrogate specimens from remote clinics were STI positive.

Conclusions
This is by far the largest study addressing the potential environmental contamination of urine samples with STI agents. Positive STI tests arising from environmental contamination of urine specimens cannot be ruled out. The results emphasize that urine specimens from young children taken for STI testing should be obtained by trained staff in clean environments, and duplicate specimens should be obtained if possible.
Keywords Contamination
Diagnosis
False positive
Sexually transmitted infection
Urine
DOI http://dx.doi.org/10.1093/jpids/pit085   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
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Created: Tue, 24 Feb 2015, 12:26:29 CST