Validation of oral-nasal specimen collection for influenza and respiratory syncytial virus detection

Abstract Objective: Respiratory virus testing is routinely performed and ways to obtain specimens aside from a nasopharyngeal swab are needed for pandemic preparedness. The main objective is to validate a self-collected oral-nasal swab for the detection of Influenza and respiratory syncytial virus...

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Main Authors: Matthew Young, Yuri Suico, Omid Kyle Vojdani, Janine McCready, Kevin Katz, Scarlett Pourmatin, Manija Rahimi, Christie Vermeiren, Jeff Powis, Christopher Kandel
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:Antimicrobial Stewardship & Healthcare Epidemiology
Online Access:https://www.cambridge.org/core/product/identifier/S2732494X2500066X/type/journal_article
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Summary:Abstract Objective: Respiratory virus testing is routinely performed and ways to obtain specimens aside from a nasopharyngeal swab are needed for pandemic preparedness. The main objective is to validate a self-collected oral-nasal swab for the detection of Influenza and respiratory syncytial virus (RSV). Design: Diagnostic test validation of a self-collected oral nasal swab as compared to a provider-collected nasopharyngeal swab. Setting: Emergency Department at Michael Garron Hospital. Participants: Consecutive individuals who presented to the Emergency Department with a suspected viral upper respiratory tract infection were included if they self-collected an oral-nasal swab. Individuals testing positive for Influenza or RSV along with randomly selected participants who tested negative were eligible for inclusion. Interventions: All participants had the paired oral-nasal swab tested using a multiplex respiratory virus polymerase chain reaction for the three respiratory pathogens and compared to the nasopharyngeal swab. Results: 48 individuals tested positive for Influenza, severe acute respiratory coronavirus virus 2 (SARS-CoV-2) or RSV along with 80 who tested negative. 110 were symptomatic with the median time from symptom onset to testing of 1 day (interquartile range 2–5 days). Using the clinical nasopharyngeal swab as the reference standard, the sensitivity was 0.75 (95% CI, 0.43–0.95) and specificity was 0.99 (95% CI, 0.93–1.00) for RSV, sensitivity is 0.67 (95% CI, 0.49–0.81) and specificity is 0.96 (95% CI, 0.89–0.99) for Influenza. Conclusions: Multiplex testing with a self-collected oral-nasal swab for Influenza and RSV is not an acceptable substitute for a healthcare provider collected nasopharyngeal swab primarily due to suboptimal Influenza test characteristics.
ISSN:2732-494X