Identification of Respiratory Viruses in Adults: Nasopharyngeal versus Oropharyngeal Sampling
Identification of Respiratory Viruses in Adults: Nasopharyngeal versus Oropharyngeal Sampling
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DOI：
10.1128/jcm.00886-09
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发表时间：
2009-11-01
影响因子：
9.4
通讯作者：
Shemer-Avni, Yonat
中科院分区：
文献类型：
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作者：
Lieberman, David;Lieberman, Devora;Shemer-Avni, Yonat
识别成人呼吸道病毒的最佳方法尚未建立。这项研究的目的是比较三种采样方法对这一目的的敏感性。包括1000名参与者(平均年龄63.1+/-17.8岁)。其中，550名患者因急性发热性下呼吸道感染住院，450名为对照组。分别从受试者口咽拭子(OPS)、鼻咽拭子(NPS)和鼻咽冲洗液(NPW)中采集标本，采用基于多重水解探针的实时定量逆转录-聚合酶链式反应(RT-PCR)检测12种呼吸道病毒。如果通过至少一种抽样方法确定了病毒，则患者被定义为特定病毒阳性。总共在244名参与者中发现了251种病毒。对于任何病毒的检测，OPS、NPS和NPW的敏感度分别为54.2%、73.3%和84.9%(OPS与NPS和NPW，P<；0.00001；NPS与NPW，P<；0.003)。只有用三种方法采样才能获得最大的灵敏度。当分别分析流感病毒、冠状病毒和鼻病毒时，三种采样方法的敏感性等级相同。三种采样方法对呼吸道合胞病毒的敏感率相同。我们得出结论：鼻咽标本比口咽标本具有更高的敏感率，在成人呼吸道病毒鉴定中使用NPW比使用带有刚性棉签的NPS具有更高的敏感率。为了最大限度地检测呼吸道病毒，需要使用所有这三种方法进行采样。
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.