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    Contaminated fingers: a potential cause of Chlamydia trachomatis-positive urine specimens

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    Author
    Giffard, PM; Lilliebridge, RA; Wilson, J; Murray, G; Phillips, S; Tabrizi, SN; Garland, SM; Martin, L; Singh, G; Tong, SYC; ...
    Date
    2018-02-01
    Source Title
    Sexually Transmitted Infections
    Publisher
    BMJ PUBLISHING GROUP
    University of Melbourne Author/s
    Tabrizi, Sepehr; Wark, Suzanne; Tong, Steven; Andersson, Patiyan; Murray, Gerald
    Affiliation
    Obstetrics and Gynaecology
    Infectious Diseases
    Microbiology and Immunology
    Metadata
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    Document Type
    Journal Article
    Citations
    Giffard, P. M., Lilliebridge, R. A., Wilson, J., Murray, G., Phillips, S., Tabrizi, S. N., Garland, S. M., Martin, L., Singh, G., Tong, S. Y. C., Holt, D. C. & Andersson, P. (2018). Contaminated fingers: a potential cause of Chlamydia trachomatis-positive urine specimens. SEXUALLY TRANSMITTED INFECTIONS, 94 (1), pp.32-36. https://doi.org/10.1136/sextrans-2016-053081.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/259441
    DOI
    10.1136/sextrans-2016-053081
    Abstract
    OBJECTIVES: The detection of an STI agent in a urogenital tract (UGT) specimen from a young child is regarded as being indicative of sexual abuse. However, the probabilities of contamination events that could conceivably lead to STI positive specimens in the absence of sexual contact are unclear. The objective was to estimate the potential for fingers that have come in contact with Chlamydia trachomatis-positive urine to detectably contaminate C. trachomatis-negative urine. METHODS: The study design was based on self-experimentation. Dilutions of C. trachomatis elementary bodies (EBs) were prepared. A participant contacted an EB dilution then a urine surrogate specimen. The experiment was performed by three participants using three C. trachomatis isolates, of genotype E, F and B. Two surrogate urine contact methods were used to mimic contamination of a carer assisting with a child's urine collection. All EB dilutions and urine surrogate specimens were subjected to C. trachomatis assay and quantification in a real-time PCR-based diagnostic system. RESULTS: The amplimer crossing point (Cq) for EB dilutions was 10.0±1.6 less than for corresponding finger contacted urine specimens, which corresponds to ~10 µL of EB suspension transferred. This was largely independent of participant identity, C. trachomatis strain or EB dilution. Hand decontamination led to large reductions in EBs transferred, but transfer remained consistently detectable. Recent Cq data from C. trachomatis-positive clinical urine specimens were collated, and 20% clearly contained sufficient C. trachomatis to detectably contaminate another specimen by finger-mediated transfer, as in this experiment. CONCLUSIONS: This study directly demonstrated the potential for urine contaminated fingers to convert a C. trachomatis-negative urine specimen to C. trachomatis positive as a result of contact. Accordingly, procedures for urine specimen collection, particularly from children, need to be designed to prevent contamination.

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