title: Evaluation and clinical validation of an alcohol-based transport medium for preservation and inactivation of respiratory viruses.
abstract: The clinical and public health importance of influenza and other respiratory viruses has accelerated the development of highly sensitive molecular diagnostics, but data are limited regarding preanalytical stages of diagnostic testing. We evaluated CyMol, an alcohol-based transport medium, for its ability to maintain specimen integrity for up to 21 days of storage at various temperatures; for its ability to inactivate virus; and for its compatibility with antigen- or nucleic acid-based diagnostics for respiratory viruses in clinical samples. In mock-infected samples, both universal transport medium (UTM-RT) and CyMol maintained equivalent viral quantities for at least 14 days at room temperature or colder, whereas a dry swab collection maintained viral quantities only if refrigerated or frozen. CyMol inactivated influenza virus within 5 min of sample immersion. UTM-RT- and CyMol-collected nasal swab specimens from 73 symptomatic students attending a campus health clinic were positive for a respiratory virus in 56.2% of subjects by multiplex PCR testing, including influenza A and B viruses, rhinovirus/enteroviruses, coronaviruses, respiratory syncytial virus, parainfluenza viruses, metapneumovirus, and adenovirus. Detection by PCR was equivalent in UTM-RT- and CyMol-collected specimens and in self- and staff-collected swabs. Direct fluorescent antibody (DFA) testing was substantially less sensitive (23.3%) than multiplex PCR, and DFA testing from UTM-RT-collected swabs was more sensitive than that from CyMol-collected swabs. These data indicate that an alcohol-based transport medium such as CyMol preserves respiratory virus integrity, rapidly inactivates viruses, and is compatible with PCR-based respiratory diagnostics.
authors.affiliation: St Joseph’s Healthcare, Hamilton, Ontario, Canada.
authors.forename: Kathy
authors.initials: K
authors.lastname: Luinstra
authors.forename: Astrid
authors.initials: A
authors.lastname: Petrich
authors.forename: Santina
authors.initials: S
authors.lastname: Castriciano
authors.forename: Mona
authors.initials: M
authors.lastname: Ackerman
authors.forename: Sylvia
authors.initials: S
authors.lastname: Chong
authors.forename: Susan
authors.initials: S
authors.lastname: Carruthers
authors.forename: Brenna
authors.initials: B
authors.lastname: Ammons
authors.forename: James B
authors.initials: JB
authors.lastname: Mahony
authors.forename: Marek
authors.initials: M
authors.lastname: Smieja
mesh_terms: D000438:Alcohols / Q000494:pharmacology; D004202:Disinfectants / Q000494:pharmacology; D006801:Humans; D016133:Polymerase Chain Reaction; D011309:Preservation, Biological / Q000379:methods*; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000821:virology; D013048:Specimen Handling / Q000379:methods*; D014773:Virology / Q000379:methods*; D014777:Virus Diseases / Q000175:diagnosis* / Q000821:virology; D038301:Virus Inactivation; D014780:Viruses / Q000302:isolation & purification*
chemical_list: D000438:Alcohols; D004202:Disinfectants