Comparison between Saliva and Nasopharyngeal Swab Specimens for Detection of Respiratory Viruses by Multiplex Reverse Transcription-PCR.
Nasopharyngeal swabs (NPSs) are being widely used as specimens for multiplex real-time reverse transcription (RT)-PCR for respiratory virus detection. However, it remains unclear whether NPS specimens are optimal for all viruses targeted by multiplex RT-PCR. In addition, the procedure to obtain NPS specimens causes coughing in most patients, which possibly increases the risk of nosocomial spread of viruses. In this study, paired NPS and saliva specimens were collected from 236 adult male patients with suspected acute respiratory illnesses. Specimens were tested for 16 respiratory viruses by multiplex real-time RT-PCR. Among the specimens collected from the 236 patients, at least 1 respiratory virus was detected in 183 NPS specimens (77.5%) and 180 saliva specimens (76.3%). The rates of detection of respiratory viruses were comparable for NPS and saliva specimens (P = 0.766). Nine virus species and 349 viruses were isolated, 256 from NPS specimens and 273 from saliva specimens (P = 0.1574). Adenovirus was detected more frequently in saliva samples (P < 0.0001), whereas influenza virus type A and human rhinovirus were detected more frequently in NPS specimens (P = 0.0001 and P = 0.0289, respectively). The possibility of false-positive adenovirus detection from saliva samples was excluded by direct sequencing. In conclusion, neither of the sampling methods was consistently more sensitive than the other. We suggest that these cost-effective methods for detecting respiratory viruses in mixed NPS-saliva specimens might be valuable for future studies.
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Young-Gon
YG
Kim
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea 84068@hanmail.net.
Seung Gyu
SG
Yun
Armed Forces Medical Research Institute, Daejeon, Republic of Korea.
Min Young
MY
Kim
Chungcheongnam-Do Health and Environment Research Institute, Hongseong, Republic of Korea.
Kwisung
K
Park
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Chi Hyun
CH
Cho
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Soo Young
SY
Yoon
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Myung Hyun
MH
Nam
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Chang Kyu
CK
Lee
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Yun-Jung
YJ
Cho
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Chae Seung
CS
Lim
D000328:Adult; D006801:Humans; D008297:Male; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D009305:Nasopharynx / Q000821:virology*; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012463:Saliva / Q000821:virology*; D013048:Specimen Handling / Q000379:methods*; D014780:Viruses / Q000302:isolation & purification*; D055815:Young Adult
RT-PCR; nasopharyngeal swab; respiratory virus; saliva