The role of the microbiology laboratory in the investigation of child sexual abuse

Detection of a sexually transmitted pathogen in a child is suggestive of sexual abuse, Consequently, there are very strong clinical, social and legal reasons for diagnosing sexually transmitted disease in children correctly, Carefully considered protocols should be established for all stages of the microbiological investigation, All procedures, from specimen collection to report generation, should be undertaken to the highest possible standard with appropriate documentation, For the more commonly identified sexually transmitted pathogens in the paediatric population, the gold standard of diagnosis in the microbiology laboratory remains culture in vitro because this method offers maximum specificity, Whenever possible, culture must be followed by appropriate confirmatory tests, This highly exacting approach has significant resource and organisational implications and some tests may have to be centralised, The effective provision of an appropriate service for these cases is dependent on the local laboratory collaborating closely with hospital paediatricians and other microbiology laboratories.