Flocked nasal swab versus nasopharyngeal aspirate for detection of respiratory tract viruses in immunocompromised adults: a matched comparative study

BMC Infectious Diseases

Research Article

Maria Rotzén-Östlund¹  Lars Öhrmalm²  Michelle Wong²  Thomas Tolfvenstam²  Oscar Norbeck²  Kristina Broliden² 

[1] Department of Clinical Microbiology, Karolinska University Hospital and Department of Microbiology, Tumor and Cell biology, Karolinska Institutet, Stockholm, Sweden;Department of Medicine, Solna, Infectious Disease Unit, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, SE-171 76, Stockholm, Sweden;

关键词: Chronic Lymphocytic Leukemia;    Febrile Neutropenia;    Respiratory Virus;    Nasal Swab;    Viral Nucleic Acid;   

DOI  :  10.1186/1471-2334-10-340

 received in 2010-09-08, accepted in 2010-11-26,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundSeveral studies have compared nasal swabs to the more invasive nasopharyngeal aspirate (NPA) for detection of respiratory viruses. Mostly, the comparisons have been performed on immunocompetent children with upper respiratory tract symptoms. The results range from a relatively poor sensitivity for the swabs to an even higher sensitivity than for the NPA. We aimed to investigate the sensitivity of a flocked nasal swab (fNS) on immunocompromised adults with febrile neutropenia.MethodsDuring 16 months, adults with a hematological disorder presenting with febrile neutropenia were enrolled in the study. Paired samples of the fNS and NPA were collected in the outer part of the nasal cavity and the nasopharynx, respectively. The samples were analyzed regarding a panel of 15 respiratory viruses by means of quantitative polymerase chain reaction. Furthermore, as an indirect measure of cell yield by either method, the copy number of the human beta actin gene was also determined. Cohen's kappa was calculated as a measure of agreement of the results obtained from either method. Wilcoxon signed-rank test was used for comparison of cell yield.ResultsA total of 98 paired samples from a total of 89 patients were collected. Twenty of the pairs had virus detected in at least one of the specimens; 11 in both, 7 in NPA only, and 2 in fNS only. For the fNS, the overall sensitivity for any virus and for rhinovirus only was 65% and 78%, respectively. NPA was significantly superior to the fNS in collecting epithelial cells.ConclusionWe found the overall sensitivity of 65% to be too low to replace NPA with this sampling technique in this patient category.

【 授权许可】

CC BY   
© Öhrmalm et al; licensee BioMed Central Ltd. 2010