Kim Young-Gon, Yun Seung Gyu, Kim Min Young, Park Kwisung, Cho Chi Hyun, Yoon Soo Young, Nam Myung Hyun, Lee Chang Kyu, Cho Yun-Jung, Lim Chae Seung
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
Department of Laboratory Medicine, Korea University College of Medicine, Seoul, Republic of Korea
J Clin Microbiol. 2016 Dec 28;55(1):226-233. doi: 10.1128/JCM.01704-16. Print 2017 Jan.
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.
鼻咽拭子（NPS）被广泛用作多重实时逆转录（RT）-PCR检测呼吸道病毒的标本。然而，NPS标本是否对多重RT-PCR检测的所有病毒均为最佳选择仍不清楚。此外，获取NPS标本的操作会导致大多数患者咳嗽，这可能会增加病毒在医院内传播的风险。在本研究中，从236例疑似急性呼吸道疾病的成年男性患者中采集了配对的NPS和唾液标本。通过多重实时RT-PCR对标本进行16种呼吸道病毒检测。在从236例患者采集的标本中，183份NPS标本（77.5%）和180份唾液标本（76.3%）中至少检测到1种呼吸道病毒。NPS和唾液标本中呼吸道病毒的检出率相当（P = 0.766）。分离出9种病毒和349株病毒，256株来自NPS标本，273株来自唾液标本（P = 0.1574）。腺病毒在唾液样本中检出频率更高（P < 0.0001），而甲型流感病毒和人鼻病毒在NPS标本中检出频率更高（分别为P = 0.0001和P = 0.0289）。通过直接测序排除了唾液样本中腺病毒检测假阳性的可能性。总之，两种采样方法均不存在始终比另一种更敏感的情况。我们认为，这些用于检测混合NPS-唾液标本中呼吸道病毒的经济有效方法可能对未来研究具有重要价值。
