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Identification of Respiratory Viruses in Adults: Nasopharyngeal versus Oropharyngeal Sampling

Identifieur interne : 000037 ( PascalFrancis/Curation ); précédent : 000036; suivant : 000038

Identification of Respiratory Viruses in Adults: Nasopharyngeal versus Oropharyngeal Sampling

Auteurs : David Lieberman [Israël] ; Devora Lieberman [Israël] ; Avi Shimoni [Israël] ; Ayelet Keren-Naus [Israël] ; Rachel Steinberg [Israël] ; Yonat Shemer-Avni [Israël]

Source :

RBID : Pascal:09-0474236

Descripteurs français

English descriptors

Abstract

The optimal method for identifying respiratory viruses in adults has not been established. The objective of the study was to compare the sensitivities of three sampling methods for this purpose. One thousand participants (mean age, 63.1 ± 17.8 years) were included. Of these, 550 were patients hospitalized for acute febrile lower respiratory tract infections and 450 were controls. Oropharyngeal swabs (OPS), nasopharyngeal swabs (NPS), and nasopharyngeal washings (NPW) were obtained from each participant and were tested for 12 respiratory viruses by a multiplex hydrolysis probes-based quantitative real-time reverse transcription-PCR. Patients were defined as positive for a specific virus if the virus was identified by at least one sampling method. In all, 251 viruses were identified in 244 participants. For the detection of any virus, the sensitivity rates for OPS, NPS, and NPW were 54.2%, 73.3%, and 84.9%, respectively (for OPS versus NPS and NPW, P < 0.00001; for NPS versus NPW, P < 0.003). Maximal sensitivity was obtained only with sampling by all three methods. The same gradation of sensitivity for the three sampling methods was found when influenza viruses, corona-viruses, and rhinoviruses were analyzed separately. The three sampling methods yielded equal sensitivity rates for respiratory syncytial virus. We conclude that nasopharyngeal sampling has a higher rate of sensitivity than oropharyngeal sampling and that the use of NPW has a higher rate of sensitivity than the use of NPS with a rigid cotton swab for the identification of respiratory viruses in adults. Sampling by all three methods is required for the maximal detection of respiratory viruses.
pA  
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A02 01      @0 JCMIDW
A03   1    @0 J. clin. microbiol. : (Print)
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A06       @2 11
A08 01  1  ENG  @1 Identification of Respiratory Viruses in Adults: Nasopharyngeal versus Oropharyngeal Sampling
A11 01  1    @1 LIEBERMAN (David)
A11 02  1    @1 LIEBERMAN (Devora)
A11 03  1    @1 SHIMONI (Avi)
A11 04  1    @1 KEREN-NAUS (Ayelet)
A11 05  1    @1 STEINBERG (Rachel)
A11 06  1    @1 SHEMER-AVNI (Yonat)
A14 01      @1 Pulmonary Unit, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev @2 Beer-Sheva @3 ISR @Z 1 aut.
A14 02      @1 Division of Internal Medicine, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev @2 Beer-Sheva @3 ISR @Z 1 aut. @Z 2 aut. @Z 3 aut.
A14 03      @1 Department of Geriatric Medicine, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev @2 Beer-Sheva @3 ISR @Z 2 aut.
A14 04      @1 Laboratory of Clinical Virology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev @2 Beer-Sheva @3 ISR @Z 4 aut. @Z 5 aut. @Z 6 aut.
A20       @1 3439-3443
A21       @1 2009
A23 01      @0 ENG
A43 01      @1 INIST @2 17088 @5 354000171402790070
A44       @0 0000 @1 © 2009 INIST-CNRS. All rights reserved.
A45       @0 16 ref.
A47 01  1    @0 09-0474236
A60       @1 P
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A64 01  1    @0 Journal of clinical microbiology : (Print)
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C01 01    ENG  @0 The optimal method for identifying respiratory viruses in adults has not been established. The objective of the study was to compare the sensitivities of three sampling methods for this purpose. One thousand participants (mean age, 63.1 ± 17.8 years) were included. Of these, 550 were patients hospitalized for acute febrile lower respiratory tract infections and 450 were controls. Oropharyngeal swabs (OPS), nasopharyngeal swabs (NPS), and nasopharyngeal washings (NPW) were obtained from each participant and were tested for 12 respiratory viruses by a multiplex hydrolysis probes-based quantitative real-time reverse transcription-PCR. Patients were defined as positive for a specific virus if the virus was identified by at least one sampling method. In all, 251 viruses were identified in 244 participants. For the detection of any virus, the sensitivity rates for OPS, NPS, and NPW were 54.2%, 73.3%, and 84.9%, respectively (for OPS versus NPS and NPW, P < 0.00001; for NPS versus NPW, P < 0.003). Maximal sensitivity was obtained only with sampling by all three methods. The same gradation of sensitivity for the three sampling methods was found when influenza viruses, corona-viruses, and rhinoviruses were analyzed separately. The three sampling methods yielded equal sensitivity rates for respiratory syncytial virus. We conclude that nasopharyngeal sampling has a higher rate of sensitivity than oropharyngeal sampling and that the use of NPW has a higher rate of sensitivity than the use of NPS with a rigid cotton swab for the identification of respiratory viruses in adults. Sampling by all three methods is required for the maximal detection of respiratory viruses.
C02 01  X    @0 002A05
C03 01  X  FRE  @0 Identification @5 05
C03 01  X  ENG  @0 Identification @5 05
C03 01  X  SPA  @0 Identificación @5 05
C03 02  X  FRE  @0 Prélèvement @5 06
C03 02  X  ENG  @0 Samplings @5 06
C03 02  X  SPA  @0 Toma de muestra @5 06
C03 03  X  FRE  @0 Microbiologie @5 07
C03 03  X  ENG  @0 Microbiology @5 07
C03 03  X  SPA  @0 Microbiología @5 07
N21       @1 341
N44 01      @1 OTO
N82       @1 OTO

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<div type="abstract" xml:lang="en">The optimal method for identifying respiratory viruses in adults has not been established. The objective of the study was to compare the sensitivities of three sampling methods for this purpose. One thousand participants (mean age, 63.1 ± 17.8 years) were included. Of these, 550 were patients hospitalized for acute febrile lower respiratory tract infections and 450 were controls. Oropharyngeal swabs (OPS), nasopharyngeal swabs (NPS), and nasopharyngeal washings (NPW) were obtained from each participant and were tested for 12 respiratory viruses by a multiplex hydrolysis probes-based quantitative real-time reverse transcription-PCR. Patients were defined as positive for a specific virus if the virus was identified by at least one sampling method. In all, 251 viruses were identified in 244 participants. For the detection of any virus, the sensitivity rates for OPS, NPS, and NPW were 54.2%, 73.3%, and 84.9%, respectively (for OPS versus NPS and NPW, P < 0.00001; for NPS versus NPW, P < 0.003). Maximal sensitivity was obtained only with sampling by all three methods. The same gradation of sensitivity for the three sampling methods was found when influenza viruses, corona-viruses, and rhinoviruses were analyzed separately. The three sampling methods yielded equal sensitivity rates for respiratory syncytial virus. We conclude that nasopharyngeal sampling has a higher rate of sensitivity than oropharyngeal sampling and that the use of NPW has a higher rate of sensitivity than the use of NPS with a rigid cotton swab for the identification of respiratory viruses in adults. Sampling by all three methods is required for the maximal detection of respiratory viruses.</div>
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