Genital Swab Culture

Brett Crawley
Clinical features of Sexually-Transmitted
Diseases

 Urethritis
 Cervicitis Discharge
 Vaginitis
 Genital ulcers

 Proctitis
 Pharyngitis
 Urethritis

 Clinical symptoms : urethral discharge &

dysuria

 Classification :
– Gonococcal urethritis : Neisseria
gonorrhoeas
– Non-gonococcal urethritis : Chlamydia
trachomatis, Ureaplasma urealyticum,
Trichomonas vaginalis
 Vaginitis

 Abnormal vaginal discharge

 Common aetiology :
– Trichomonas vaginalis
– Candida albicans

 Bacterial vaginosis :
– Gardnerella vaginalis
 Cervicitis

 Abnormal vaginal discharge

 Common aetiology :
– Neisseria gonorrhoeae
– Chlamydia trachomatis
 Type of specimen

 Male:
– Urethral swab
 Female:
– Vaginal swab
– Cervical swab
 Laboratory diagnosis
of gonococcal infection

 Laboratory tests :
– Direct microscopy
(Gram staining)
– Culture

 Specimens :
– Urethral swab
– Cervical swab
– Pharyngeal swab
– Rectal swab
 Direct microscopy
of gonococcal infection

 Make smear on objective

glass, air dry, then fix by
passing through flame (3-4x)

 Report:
– Epithelial cells
– Leukocytes
– Bacteria: Gram negative rods,
Gram positive cocci

– Intracellular and/or extracellular

Gram negative diplococci
 Culture for gonococcal infection

 Direct inoculation on Thayer-Martin media or

 Use of transport media: Amies, Transgrow, Jembec

 If delayed: keep at room temperature, maximum time:

12 hours after specimen collection
 Laboratory diagnosis
of Chlamydia trachomatis

 Laboratory tests:
– Direct microscopy (Giemsa staining)
– Antigen detection:
 Direct immunofluorescence assay
 Enzyme immunoassay
– Tissue culture
– Nucleic acid amplification tests (PCR, LCR, etc)

 Specimens:
– Lymph nodes: pus (aspiration with syringe and needle)
– Urethra: cotton or calcium alginate swabs
– Endocervical canal: cotton or calcium alginate swabs or
cyto-brush
 Direct microscopy
of C. trachomatis

 Make a smear on objective glass, air dry, then fix

with absolute methanol for 2-3 minutes

 Report:
– The presence of intracellular elementary bodies
 Immunofluorescence assay
of C. trachomatis

 Make a smear on objective glass, air dry, then fix

with acetone for 2-3 minutes
 Add specific antibody labeled with FITC or other
fluorescent dye

 Report:
– Presence of intracellular fluorescent elementary bodies
 Laboratory diagnosis
of candidiasis

 Direct microscopy with 10% KOH

 Fungal culture

 Specimen:
– vaginal discharge (collected from
posterior fornics )
– urethral discharge
Laboratory diagnosis
of candidiasis
 Laboratory diagnosis of
bacterial vaginosis

 3 out of 4 signs / symptoms:

– Homogenous secretion
– Vaginal discharge pH > 4.5
– Fishy odour after addition of 10% KOH (Whiff test)
– Presence of clue cells

 Direct microscopy:
– Wet mount
– Gram staining
 Culture is not recommended
Laboratory diagnosis of
bacterial vaginosis

Clue cells
 Laboratory diagnosis of
bacterial vaginosis

Clue cells