Comparison of nasopharyngeal and oropharyngeal swabs for the diagnosis of eight respiratory viruses by real-time reverse transcription-PCR assays.
Comparison of nasopharyngeal and oropharyngeal swabs for the diagnosis of eight respiratory viruses by real-time reverse transcription-PCR assays.
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DOI：
10.1371/journal.pone.0021610
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Katz MA
中科院分区：
文献类型：
--
作者：
Kim C;Ahmed JA;Eidex RB;Nyoka R;Waiboci LW;Erdman D;Tepo A;Mahamud AS;Kabura W;Nguhi M;Muthoka P;Burton W;Breiman RF;Njenga MK;Katz MA
许多急性呼吸道疾病监测系统收集和测试鼻咽(NP)和/或口咽(OP)拭子样本，但很少有研究评估NP和OP样本的相对性能指标。我们在肯尼亚的两个呼吸道监测点分别收集了流行性感冒样疾病或严重急性呼吸道疾病的儿童和成人患者的NP和OP拭子配对。用实时定量逆转录聚合酶链式反应(qRT-PCR)检测8种呼吸道病毒。对特定病毒的阳性定义为在任一拭子中检测到病毒核酸。在2331例NP/OP配对标本中，1402例(60.1%)至少检出一种病毒，393例(16.9%)检出一种以上病毒。总体而言，OP拭子对腺病毒(72.4%比57.6%，p<；0.01)和2009年甲型H1N1流感大流行病毒(91.2%比70.4%，p<；0.01)的敏感度明显高于NP拭子。NP标本对乙型流感病毒(83.3%vs.61.5%，p = 0.02)、副流感病毒2型(85.7%，vs.39.3%，p<；0.01)和副流感病毒3型(83.9%vs.67.4%，p<；0.01)的敏感性较高。这两种方法对人类偏肺病毒、甲型流感病毒(H3N2)、副流感病毒1或呼吸道合胞病毒没有显著差异。在测试的八种病毒中，敏感性是不同的；没有一种样本始终比另一种更有效。对于使用qRT-PCR的呼吸系统疾病监测项目，其目的是最大限度地提高对大量病毒的敏感性，收集NP和OP联合样本将是最有效的方法。
Many acute respiratory illness surveillance systems collect and test nasopharyngeal (NP) and/or oropharyngeal (OP) swab specimens, yet there are few studies assessing the relative measures of performance for NP versus OP specimens. We collected paired NP and OP swabs separately from pediatric and adult patients with influenza-like illness or severe acute respiratory illness at two respiratory surveillance sites in Kenya. The specimens were tested for eight respiratory viruses by real-time reverse transcription-polymerase chain reaction (qRT-PCR). Positivity for a specific virus was defined as detection of viral nucleic acid in either swab. Of 2,331 paired NP/OP specimens, 1,402 (60.1%) were positive for at least one virus, and 393 (16.9%) were positive for more than one virus. Overall, OP swabs were significantly more sensitive than NP swabs for adenovirus (72.4% vs. 57.6%, p<0.01) and 2009 pandemic influenza A (H1N1) virus (91.2% vs. 70.4%, p<0.01). NP specimens were more sensitive for influenza B virus (83.3% vs. 61.5%, p = 0.02), parainfluenza virus 2 (85.7%, vs. 39.3%, p<0.01), and parainfluenza virus 3 (83.9% vs. 67.4%, p<0.01). The two methods did not differ significantly for human metapneumovirus, influenza A (H3N2) virus, parainfluenza virus 1, or respiratory syncytial virus. The sensitivities were variable among the eight viruses tested; neither specimen was consistently more effective than the other. For respiratory disease surveillance programs using qRT-PCR that aim to maximize sensitivity for a large number of viruses, collecting combined NP and OP specimens would be the most effective approach.
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