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Why oral antiseptic mouth rinsing before sputum collection cannot reduce contamination rate of mycobacterial culture in Burkina-Faso

Antoinette Kabore, Juliette Tranchot-Diallo, Adama Sanou, Hervé Hien, Géraldine Daneau, Michel Kireopori Gomgnimbou, Nicolas Meda, Lassana Sangaré

Abstract


Background: Tuberculosis (TB) diagnosis by culture in most resource-limited settings is hampered by high contamination rate varying up to 31%. Reduction of oral microorganism loads by mouth rinse with antiseptic before sputum collection showed a reduction of contamination. Moreover, knowing the characteristic of residual contaminant microorganisms would be an asset to understand contamination issues.

Objectives: The aim of this study was to evaluate the effects of mouth rinsing with chlorhexidine on mycobacteria culture contaminations and to characterize morphologically the residual contaminants.

Methods: We consecutively included 158 patients in a TB center. Each of them supplied two sputa: The first before mouth rinse, and the second after 60sec of mouth rinsing with chlorhexidine (0.1%).  Petroff method   and Lowenstein-Jensen media were used for sputum decontamination and inoculation respectively. The contamination rates were compared, and the type of residual contaminants were characterized and compared.

Results: The contamination rate did not differ before and after the mouth rinse (respectively 58/150 (39 %) vs 61/150 (41 %), p=0.7). The major residual contaminants were Gram positive spore forming bacteria (94%).

Conclusion: Chlorhexidine mouth rinsing before sputum collection did not reduce mycobacterial culture contamination rate. This is probably due to spore forming bacteria, highlighted as major residual contaminants.

Keywords: Oral rinse, sputum, Mycobacteria culture, contamination rate, residual contaminants. 




AJOL African Journals Online