Kenya Medical Research Institute - Center for Global Health Research, Kisumu, Kenya.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Sci Rep. 2019 Aug 2;9(1):11237. doi: 10.1038/s41598-019-47713-4.
Molecular diagnostic methods are becoming increasingly available for assessment of acute lower respiratory illnesses (ALRI). However, nasopharyngeal/oropharyngeal (NP/OP) swabs may not accurately reflect etiologic agents from the lower respiratory tract where sputum specimens are considered as a more representative sample. The pathogen yields from NP/OP against sputum specimens have not been extensively explored, especially in tropical countries. We compared pathogen yields from NP/OP swabs and sputum specimens from patients ≥18 years hospitalized with ALRI in rural Western Kenya. Specimens were tested for 30 pathogens using TaqMan Array Cards (TAC) and results compared using McNemar's test. The agreement for pathogen detection between NP/OP and sputum specimens ranged between 85-100%. More viruses were detected from NP/OP specimens whereas Klebsiella pneumoniae and Mycobacterium tuberculosis were more common in sputum specimens. There was no clear advantage in using sputum over NP/OP specimens to detect pathogens of ALRI in adults using TAC in the context of this tropical setting.
分子诊断方法在评估急性下呼吸道疾病（ALRI）方面变得越来越可用。然而，鼻咽/口咽（NP/OP）拭子可能无法准确反映下呼吸道的病原体，而下呼吸道的痰液标本被认为更具代表性。NP/OP 拭子与痰液标本的病原体产率尚未得到广泛探讨，尤其是在热带国家。我们比较了肯尼亚西部农村地区因 ALRI 住院的≥18 岁患者的 NP/OP 拭子和痰液标本中的病原体产率。使用 TaqMan 阵列卡（TAC）检测 30 种病原体，并使用 McNemar 检验比较结果。NP/OP 和痰液标本在病原体检测方面的一致性在 85-100%之间。从 NP/OP 标本中检测到更多的病毒，而肺炎克雷伯菌和结核分枝杆菌在痰液标本中更为常见。在这种热带环境下，使用 TAC 时，痰液标本在检测成人 ALRI 的病原体方面并没有明显优于 NP/OP 标本的优势。
