Evaluation of four commercial transport media for the survival of Neisseria gonorrhoeae

We evaluated four commercial transport systems with a standardized inoculum of clinical isolates of N. gonorrhoeae (NG), and assessed survival after holding for up to 48 hours at both ambient and refrigeration temperatures. Suspensions of clinical isolates of NG were standardized and adsorbed onto four transport swab types: Culturette EZ (Becton Dickinson [BD], Cockeysville, MD, USA); Cultureswab (Difco Laboratories, Detroit, MI, USA); Venturi Transystem (Copan Italia, Bovezzo, Italy); and a recently modified Starswab (Starplex Scientific, Etobicoke, ON). Swabs were plated to chocolate agar at 0, 6, 24, and 48 hours, and colonies counted. Each swab type was tested in quadruplicate with each NG strain for all time and temperature variables. There was a marked reduction in NG CFUs after only 6 hours incubation with each of the swabs tested. Survival was best using Venturi Transystem and Cultureswab transports (colony counts were reduced to 15.3% and 13.0%, respectively, at 6 hours) when compared with the Culturette EZ and Starswab (colony counts were reduced to 2.2% and 4.3%, respectively, at 6 hours). After the 24-hour holding period, 94% of the cultures from the Venturi Transystem were positive, 82% from the Cultureswab, 24% from the Starswab; and 17% from the Culturette EZ. After 48 hours, recovery dropped to 72%, 43%, 14%, and 0.04%, respectively. All of the systems tested had at least an 80% decrease in recovered colonies after only 6 hours. Further studies are required to determine how poor transport conditions influence the number of positive cultures and what the public health implications are. Of the swabs tested, Cultureswab and Venturi Transystem were most acceptable.