For an epidemiologic survey of upper respiratory tract carriers of Neisseria meningitidis or Bordetella pertussis, what is the optimal specimen for culture?

• A. Anterior nares
• B. Buccal cavity
• C. Nasopharyngeal
• D. Throat

Answer: (C)

Carriage and infection with these organisms occur most consistently in the nasopharynx, so sampling that site maximizes the chance of recovering them in culture. The posterior nasopharyngeal region harbors Neisseria meningitidis in healthy carriers and Bordetella pertussis during the early stages of infection, whereas the anterior nares, buccal cavity, or throat are less representative sites and yield lower sensitivity. A nasopharyngeal specimen thus provides the highest likelihood of detecting the bacteria when culturing, especially when prompt handling and appropriate transport media are used to preserve the organisms.