title: Comparison of nasal brush and nasopharyngeal aspirate techniques in obtaining specimens for detection of respiratory syncytial viral antigen by immunofluorescence.
abstract: Diagnosis of respiratory syncytial virus by antigen detection is dependent on obtaining adequate respiratory epithelial cells. Two specimen collection methods, nasopharyngeal aspiration (NPA) and nasal brushing (NB), were compared. Thirty-two pediatric patients with presumed viral pneumonia or bronchiolitis (34 episodes) had both NPA and NB performed. Of 34 specimens 15 were culture-positive for respiratory syncytial virus. Of these 12 NPA samples and 10 NB samples had viral inclusions by immunofluorescent antibody staining (IFA). Of culture-negative samples, 1 of 17 NB was positive by IFA. One specimen obtained by NB had too few cells to read by the IFA method. Sensitivity and specificity were 80 and 100% for NPA and 67 and 94% for NB. Total respiratory cells and IFA-positive cells (classified as few, moderate, or many) were greater with NPA; however, NB was also an effective procedure and was better tolerated by children, less expensive and easier to perform.
authors.affiliation: Department of Pediatrics, Johns Hopkins Hospital, Baltimore, MD 21205.
authors.forename: S D
authors.initials: SD
authors.lastname: Barnes
authors.forename: J M
authors.initials: JM
authors.lastname: Leclair
authors.forename: M S
authors.initials: MS
authors.lastname: Forman
authors.forename: T R
authors.initials: TR
authors.lastname: Townsend
authors.forename: G M
authors.initials: GM
authors.lastname: Laughlin
authors.forename: P
authors.initials: P
authors.lastname: Charache
mesh_terms: D000956:Antigens, Viral / Q000032:analysis*; D002675:Child, Preschool; D004848:Epithelium / Q000382:microbiology; D005455:Fluorescent Antibody Technique; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009296:Nasal Cavity / Q000382:microbiology; D009305:Nasopharynx / Q000382:microbiology; D011237:Predictive Value of Tests; D012136:Respiratory Syncytial Viruses / Q000276:immunology / Q000302:isolation & purification*; D010253:Respirovirus Infections / Q000175:diagnosis*; D013048:Specimen Handling / Q000379:methods*
chemical_list: D000956:Antigens, Viral