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A combination of naso- and oropharyngeal swabs improves the diagnostic yield of respiratory viruses in adult emergency department patients

Ek, Peter LU ; Böttiger, Blenda LU ; Dahlman, Disa LU ; Hansen, Karin B. LU ; Nyman, Mattias and Nilsson, Anna C. LU (2019) In Infectious Diseases 51(4). p.241-248
Abstract

Background: Along with the current development of molecular diagnostic methods of respiratory viruses, the bedside patient sampling techniques need to be evaluated. We here asked the question whether the addition of an oropharynx swab to the traditional nasopharynx swab might improve the diagnostic yield of multiplex PCR analysis. Ct values from the two sampling sites were compared as well as patient tolerability. Methods: In an emergency department in Malmö, Sweden, 98 adult patients with respiratory disease were sampled both from the nasopharynx and oropharynx for virus diagnostics by PCR. Results: Influenza (AH1, AH3, B), human metapneumovirus (hMPV) or respiratory syncytial virus (RSV) were detected by PCR in 58 subjects. The... (More)

Background: Along with the current development of molecular diagnostic methods of respiratory viruses, the bedside patient sampling techniques need to be evaluated. We here asked the question whether the addition of an oropharynx swab to the traditional nasopharynx swab might improve the diagnostic yield of multiplex PCR analysis. Ct values from the two sampling sites were compared as well as patient tolerability. Methods: In an emergency department in Malmö, Sweden, 98 adult patients with respiratory disease were sampled both from the nasopharynx and oropharynx for virus diagnostics by PCR. Results: Influenza (AH1, AH3, B), human metapneumovirus (hMPV) or respiratory syncytial virus (RSV) were detected by PCR in 58 subjects. The diagnostic yield was improved by combining nasopharyngeal and oropharyngeal sampling–a virus was detected in another 6 patients compared to traditional nasopharyngeal sampling (p =.031, McNemar’s test). In 38/55 subjects viral load was higher in the nasopharynx than in the oropharynx. Self-reported discomfort was significantly lower from oropharyngeal sampling than from nasopharyngeal sampling. Conclusions: Adding an oropharynx sample to a nasopharynx sample increased the diagnostic yield of respiratory viruses. Oropharyngeal sampling was well tolerated.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Influenza, nasopharynx, oropharynx, PCR, viral diagnostics
in
Infectious Diseases
volume
51
issue
4
pages
241 - 248
publisher
Informa Healthcare
external identifiers
  • scopus:85061619514
  • pmid:30760088
ISSN
2374-4235
DOI
10.1080/23744235.2018.1546055
project
Community-acquired pneumonia (CAP) - predictive agents and biomarkers for management and serious disease
language
English
LU publication?
yes
id
7b4af424-11ec-44a8-8a98-53a95d668399
date added to LUP
2019-02-26 08:22:09
date last changed
2024-04-16 01:01:15
@article{7b4af424-11ec-44a8-8a98-53a95d668399,
  abstract     = {{<p>Background: Along with the current development of molecular diagnostic methods of respiratory viruses, the bedside patient sampling techniques need to be evaluated. We here asked the question whether the addition of an oropharynx swab to the traditional nasopharynx swab might improve the diagnostic yield of multiplex PCR analysis. Ct values from the two sampling sites were compared as well as patient tolerability. Methods: In an emergency department in Malmö, Sweden, 98 adult patients with respiratory disease were sampled both from the nasopharynx and oropharynx for virus diagnostics by PCR. Results: Influenza (AH1, AH3, B), human metapneumovirus (hMPV) or respiratory syncytial virus (RSV) were detected by PCR in 58 subjects. The diagnostic yield was improved by combining nasopharyngeal and oropharyngeal sampling–a virus was detected in another 6 patients compared to traditional nasopharyngeal sampling (p =.031, McNemar’s test). In 38/55 subjects viral load was higher in the nasopharynx than in the oropharynx. Self-reported discomfort was significantly lower from oropharyngeal sampling than from nasopharyngeal sampling. Conclusions: Adding an oropharynx sample to a nasopharynx sample increased the diagnostic yield of respiratory viruses. Oropharyngeal sampling was well tolerated.</p>}},
  author       = {{Ek, Peter and Böttiger, Blenda and Dahlman, Disa and Hansen, Karin B. and Nyman, Mattias and Nilsson, Anna C.}},
  issn         = {{2374-4235}},
  keywords     = {{Influenza; nasopharynx; oropharynx; PCR; viral diagnostics}},
  language     = {{eng}},
  month        = {{02}},
  number       = {{4}},
  pages        = {{241--248}},
  publisher    = {{Informa Healthcare}},
  series       = {{Infectious Diseases}},
  title        = {{A combination of naso- and oropharyngeal swabs improves the diagnostic yield of respiratory viruses in adult emergency department patients}},
  url          = {{http://dx.doi.org/10.1080/23744235.2018.1546055}},
  doi          = {{10.1080/23744235.2018.1546055}},
  volume       = {{51}},
  year         = {{2019}},
}