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; Martin, Louise; Spencer, Emma; Delima, Jennifer; Singh, Gurmeet; McCann, Frances V.; Hudson, Carolyn Brauer; Johns, Tracy; Giffard, Philip M.

doi:10.1093/jpids/pit085

Cited by 12 publications

(26 citation statements)

References 7 publications

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“…The study of potential sources of environmental contamination of urine samples for diagnosing sexually transmitted chlamydia provides further insight into our findings. Andersson et al swabbed a variety of environmental locations in STI clinic bathrooms, including door handles, locks, doors, walls, toilet flush buttons, and wash basins and taps for evidence of contamination using Aptima 2 Combo Assay (Gen Probe) [19]. They found anywhere from 3.6 to 9.4% of swabs were positive for C. trachomatis, and included sites like door handles and locks, washbasin taps and wash basin edges.…”

Section: Discussionmentioning

confidence: 99%

Evidence for contamination with C. trachomatis in the household environment of children with active Trachoma: A cross-sectional study in Kongwa, Tanzania

West

Nanji

Mkocha³

et al. 2019

PLoS Negl Trop Dis

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BackgroundTrachoma, a conjunctivitis caused by repeated infections with Chlamydia trachomatis, remains a significant cause of blindness worldwide. While mass treatments with azithromycin decreases disease and infection, re-emergence occurs, indicating that elimination may require other sustainable interventions. Environmental changes largely focus on facial hygiene and latrines, but further work to identify other possible transmission targets are needed. We sought to determine, in a cross-sectional survey of households of children with active trachoma, if we could detect the presence of Chlamydia trachomatis on household objects and on family members based on sleeping and caretaking patterns. MethodsIn five villages in Kongwa, Tanzania, children

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Section: Discussionmentioning

confidence: 99%

Evidence for contamination with C. trachomatis in the household environment of children with active Trachoma: A cross-sectional study in Kongwa, Tanzania

West

Nanji

Mkocha³

et al. 2019

PLoS Negl Trop Dis

View full text Add to dashboard Cite

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“…The detailed and definitive procedure for the swab collection and analysis is described by Andersson and co-workers (2014). In summary, seven sites within the NT were included: two clinics associated with an NT Government organisation that investigates possible sexual assaults, two “sexual health” clinics in the Darwin and Alice Springs urban areas, two primary health clinics in small “regional” towns, and four primary health clinics in “remote Indigenous” communities.…”

Section: Methodsmentioning

confidence: 99%

Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections

Giffard

Andersson

et al. 2017

PeerJ

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BackgroundThe microbiome of built environment surfaces is impacted by the presence of humans. In this study, we tested the hypothesis that analysis of surface swabs from clinic toilet/bathroom yields results correlated with sexually transmitted infection (STI) notifications from corresponding human populations. We extended a previously reported study in which surfaces in toilet/bathroom facilities in primary health clinics in the Australian Northern Territory (NT) were swabbed then tested for nucleic acid from the STI agents Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. This was in the context of assessing the potential for such nucleic acid to contaminate specimens collected in such facilities. STIs are notifiable in the NT, thus allowing comparison of swab and notification data.MethodsAn assumption in the design was that while absolute built environment loads of STI nucleic acids will be a function of patient traffic density and facility cleaning protocols, the relative loads of STI nucleic acids from different species will be largely unaffected by these processes. Another assumption was that the proportion of swabs testing positive for STIs provides a measure of surface contamination. Accordingly, “STI profiles” were calculated. These were the proportions that each of the three STIs of interest contributed to the summed STI positive swabs or notifications. Three comparisons were performed, using swab data from clinics in remote Indigenous communities, clinics in small-medium towns, and a single urban sexual health clinic. These data were compared with time and place-matched STI notifications.ResultsThere were significant correlations between swab and notifications data for the both the remote Indigenous and regional data. For the remote Indigenous clinics the p values ranged from 0.041 to 0.0089, depending on data transformation and p value inference method. Further, the swab data appeared to strongly indicate known higher relative prevalence of gonorrhoeae in central Australia than in northern Australia. Similarly, the regional clinics yielded p values from 0.0088–0.0022. In contrast, swab and notifications data from the sexual health clinic were not correlated.DiscussionStrong correlations between swab and notifications were observed. However, there was evidence for limitations of this approach. Despite the correlation observed with the regional clinics data, one clinic yielded zero positive swabs for C. trachomatis, although this STI constituted 25.1% of the corresponding notifications. This could be ascribed to stochastic effects. The lack of correlation observed for sexual health clinic data was also likely due to stochastic effects. It was concluded that toilet/bathroom surface swab sampling has considerable potential for public health surveillance. The approach may be applicable in situations other than primary health clinics, and for targets other than STIs.

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Section: Methodsmentioning

confidence: 99%

“…The basis of this study was the comparison of previously published data concerning STI agents in toilet/bathroom surface swabs (Andersson et al 2014) with corresponding NT Government STI notifications data (Northern Territory Department of Health). The detailed and definitive procedure for the swab collection and analysis is described by Andersson and coworkers (Andersson et al 2014). In summary, seven sites within the NT were included: two clinics associated with an NT Government organisation that investigates possible sexual assaults, two "sexual health" clinics in the Darwin and Alice Springs urban areas, two primary health PeerJ reviewing PDF | (2017:03:16907:1:1:ACCEPTED 17 May 2017)…”

Section: Methodsmentioning

confidence: 99%

“…Recently, a longitudinal multi-site assessment of sexually transmitted infection (STI) agent nucleic acid contamination of surfaces in clinic toilet/bathroom facilities in the Australian Northern Territory (NT) was reported (Andersson et al 2014). The aim was estimation of the potential for such contamination to lead to positive STIs tests performed on urine specimens, so the study also included simulation of urine specimen collection using a synthetic urine substitute.…”

Section: Introductionmentioning

confidence: 99%

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Peer Review #1 of "Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections (v0.1)"

2017

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Background. The microbiome of built environment surfaces is impacted by the presence of humans. In this study, we tested the hypothesis that analysis of surface swabs from clinic bathroom/toilets yields results correlated with sexually transmitted infection (STI) notifications from corresponding human populations. We extended a previously reported study in which surfaces in toilet/bathroom facilities in primary health clinics in the Australian Northern Territory (NT) were swabbed then tested for nucleic acid from the sexually transmitted infection (STI) agents Chlamydia trachomatis, Neisseria gonorrhoea and Trichomonas vaginalis. This was in the context of assessing the potential for such nucleic acid to contaminate specimens collected in such facilities. STIs are notifiable in the NT, thus allowing comparison of swab and notification data. Methods. An assumption in the design was that while absolute built environment loads of STI nucleic acids will be a function of patient traffic density and facility cleaning protocols, the relative loads of STI nucleic acids from different species will be largely unaffected by these processes. Another assumption was that the proportion of swabs testing positive for STIs provides a measure of surface contamination. Accordingly, "STI profiles" were calculated. These were the proportions that each of the three STIs of interest contributed to the summed STI positive swabs or notifications. Three comparisons were performed, using swab data from clinics in remote Indigenous communities, clinics in small-medium towns, and a single urban sexual health clinic. These data were compared with time and place-matched STI notifications. Results. There was significant correlations between swab and notifications data for the both the remote Indigenous and regional data. For the remote Indigenous clinics the p values ranged from 0.041 to 0.0089, depending on data transformation and p value inference method. Further, the swab data appeared to strongly indicate known higher relative prevalence of gonorrhoea in central Australia than in northern Australia. Similarly,

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Multisite Direct Determination of the Potential for Environmental Contamination of Urine Samples Used for Diagnosis of Sexually Transmitted Infections

Cited by 12 publications

References 7 publications

Evidence for contamination with C. trachomatis in the household environment of children with active Trachoma: A cross-sectional study in Kongwa, Tanzania

Evidence for contamination with C. trachomatis in the household environment of children with active Trachoma: A cross-sectional study in Kongwa, Tanzania

Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections

Peer Review #1 of "Primary health clinic toilet/bathroom surface swab sampling can indicate community profile of sexually transmitted infections (v0.1)"

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