Ahluwalia G, Embree J, McNicol P, Law B, Hammond G W
J Clin Microbiol. 1987 May;25(5):763-7. doi: 10.1128/jcm.25.5.763-767.1987.
Paired nasopharyngeal aspirate (NPA) and nasopharyngeal swab (NPS) specimens obtained from each of 32 hospitalized infants with X-ray-confirmed pneumonia (91%) or bronchiolitis were tested for respiratory syncytial virus (RSV) infection by virus culture, the indirect immunofluorescent-antibody (IFA) technique, enzyme-linked immunosorbent assay (ELISA; Ortho Diagnostic Systems, Inc.), and spot hybridization with a human genomic probe to quantitate cellular DNA. RSV was isolated in cell cultures from 72% (23 of 32) of patients by using NPA specimens compared with 47% (15 of 32) by using NPS specimens. With tissue culture positivity as the reference test, the sensitivities of the ELISA on NPA and NPS specimens were found to be 69% (16 of 23) and 61% (14 of 23), respectively, with a specificity and a positive predictive value from both sites of 100%. The sensitivities of the IFA technique compared with the cell culture on NPA and NPS specimens were 61% (14 of 23) and 52% (12 of 23) with specificities of 89 and 78% and positive predictive values of 96 and 92%, respectively. Despite the recovery of significantly more cells (as shown by detection of more cellular DNA by using NPA specimens), virus was detected by the IFA technique or ELISA at similar frequencies in paired specimens. However, virus was recovered more often from NPA than NPS specimens by cell culture, and ELISA optical density readings and the number of RSV-positive fluorescing cells were greater for NPA specimens. NPA specimen collection was less traumatic for the patient, was an easier procedure for the physician to perform, and provided a superior laboratory specimen for RSV diagnosis than the NPS technique.
从32名经X线确诊为肺炎（91%）或细支气管炎的住院婴儿中，每人采集配对的鼻咽抽吸物（NPA）和鼻咽拭子（NPS）样本，通过病毒培养、间接免疫荧光抗体（IFA）技术、酶联免疫吸附测定（ELISA；Ortho诊断系统公司）以及与人基因组探针的斑点杂交来定量细胞DNA，检测呼吸道合胞病毒（RSV）感染情况。使用NPA样本时，72%（32例中的23例）患者的细胞培养物中分离出RSV，而使用NPS样本时这一比例为47%（32例中的15例）。以组织培养阳性作为参考检测，ELISA对NPA和NPS样本的敏感性分别为69%（23例中的16例）和61%（23例中的14例），两个部位的特异性和阳性预测值均为100%。与细胞培养相比，IFA技术对NPA和NPS样本的敏感性分别为61%（23例中的14例）和52%（23例中的12例），特异性分别为89%和78%，阳性预测值分别为96%和92%。尽管NPA样本中回收的细胞明显更多（通过检测更多细胞DNA表明），但配对样本中通过IFA技术或ELISA检测到病毒的频率相似。然而，通过细胞培养从NPA样本中回收病毒的频率高于NPS样本，并且ELISA光密度读数以及NPA样本中RSV阳性荧光细胞的数量更大。与NPS技术相比，采集NPA样本对患者造成的创伤更小，对医生来说操作更容易，并且为RSV诊断提供了更好的实验室样本。
