title: Flocked nasal swab versus nasopharyngeal aspirate in adult emergency room patients: similar multiplex PCR respiratory pathogen results and patient discomfort.
abstract: Fifty adult emergency room patients with symptoms of respiratory tract infections or acute onset of extreme fatigue were sampled by both nasopharyngeal aspirate (NPA) and flocked nasal swab (fNS). Respiratory agents were detected by a qualitative influenza PCR and an 18-valent multiplex PCR in 20 of 29 patients with a clinical diagnosis of respiratory tract infection, and in 3 of 21 without such a diagnosis. PCR detected influenza A and B in NPA samples from 11 patients and in fNS samples from 10 patients. Little or no discomfort was perceived by 60% of the patients when sampled by NPA and by 66% when sampled by fNS. We conclude that NPA and fNS were equally sensitive for detection of respiratory agents by multiplex PCR, and the two sampling methods did not differ significantly regarding discomfort perceived by patients (p = 0.171, Wilcoxon signed rank test). Hence less invasive sampling by fNS might be preferable in certain settings and situations.
authors.affiliation: a Department of Clinical Sciences , Infectious Disease Research Unit, Skåne University Hospital , Malmö , Sweden.
authors.forename: Karin B
authors.initials: KB
authors.lastname: Hansen
authors.affiliation: b Department of Infectious Diseases/Virology , Institute of Biomedicine, University of Gothenburg , Gothenburg , Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Westin
authors.affiliation: b Department of Infectious Diseases/Virology , Institute of Biomedicine, University of Gothenburg , Gothenburg , Sweden.
authors.forename: Lars-Magnus
authors.initials: LM
authors.lastname: Andersson
authors.affiliation: b Department of Infectious Diseases/Virology , Institute of Biomedicine, University of Gothenburg , Gothenburg , Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindh
authors.affiliation: c Department of Medical Microbiology, Laboratory Medicine , Region Skåne, Lund University , Malmö , Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Widell
authors.affiliation: a Department of Clinical Sciences , Infectious Disease Research Unit, Skåne University Hospital , Malmö , Sweden.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058491:Bacterial Load; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification; D009981:Influenza B virus / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009305:Nasopharynx / Q000821:virology; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000382:microbiology; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D018709:Statistics, Nonparametric; D019562:Viral Load; D055815:Young Adult
keywords: Flocked nasal swabs; discomfort; influenza; multiplex PCR; nasopharyngeal aspirates; respiratory infections