title: A patient self-collection method for longitudinal monitoring of respiratory virus infection in solid organ transplant recipients.
abstract: BACKGROUND
  Methods for the longitudinal study of respiratory virus infections are cumbersome and limit our understanding of the natural history of these infections in solid organ transplant (SOT) recipients.
  
  
  OBJECTIVE
  To assess the feasibility and patient acceptability of self-collected foam nasal swabs for detection of respiratory viruses in SOT recipients and to define the virologic and clinical course.
  
  
  METHODS
  We prospectively monitored the course of symptomatic respiratory virus infection in 18 SOT patients (14 lung, 3 liver, and 1 kidney) using patient self-collected swabs.
  
  
  RESULTS
  The initial study sample was positive in 15 patients with the following respiratory viruses: rhinovirus (6), metapneumovirus (1), coronavirus (2), respiratory syncytial virus (2), parainfluenza virus (2), and influenza A virus (2). One hundred four weekly self-collected nasal swabs were obtained, with a median of 4 samples per patient (range 1-17). Median duration of viral detection was 21 days (range 4-77 days). Additional new respiratory viruses detected during follow-up of these 15 patients included rhinovirus (3), metapneumovirus (2), coronavirus (1), respiratory syncytial virus (1), parainfluenza virus (1), and adenovirus (1). Specimen collection compliance was good; 16/18 (89%) patients collected all required specimens and 79/86 (92%) follow-up specimens were obtained within the 7 ± 3 day protocol-defined window. All participants agreed or strongly agreed that the procedure was comfortable, simple, and 13/14 (93%) were willing to participate in future studies using this procedure.
  
  
  CONCLUSIONS
  Self-collected nasal swabs provide a convenient, feasible, and patient-acceptable methodology for longitudinal monitoring of upper respiratory virus infection in SOT recipients.
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, United States.
authors.forename: Carl M
authors.initials: CM
authors.lastname: Preiksaitis
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA, United States; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Kuypers
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, United States.
authors.forename: Cynthia E
authors.initials: CE
authors.lastname: Fisher
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, WA, United States; Seattle Children's Hospital, Seattle, WA, United States; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
authors.forename: Angela P
authors.initials: AP
authors.lastname: Campbell
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA, United States; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Jerome
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA, United States; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
authors.forename: Meei-Li
authors.initials: ML
authors.lastname: Huang
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, United States; Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Boeckh
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, United States. Electronic address: limaye@uw.edu.
authors.forename: Ajit P
authors.initials: AP
authors.lastname: Limaye
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology*; D013048:Specimen Handling / Q000379:methods* / Q000592:standards; D066027:Transplant Recipients; D055815:Young Adult
keywords: Longitudinal monitoring; Respiratory virus infection; Self-collection specimens; Solid organ transplant