与医护人员采集的鼻咽标本相比，自我采集的唾液或前鼻标本中严重急性呼吸综合征冠状病毒 2 的检测。
Detection of Severe Acute Respiratory Syndrome Coronavirus 2 on Self-Collected Saliva or Anterior Nasal Specimens Compared With Healthcare Personnel-Collected Nasopharyngeal Specimens.
机构信息
Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.
Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado, USA.
出版信息
Clin Infect Dis. 2021 Jul 15;73(Suppl 1):S65-S73. doi: 10.1093/cid/ciab330.
BACKGROUND
Nasopharyngeal specimens (NPS) are commonly used for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing but can be uncomfortable for patients. Self-collected saliva specimens (SS) or anterior nasal specimens (ANS) for SARS-CoV-2 detection are less invasive, but the sensitivity of these specimen types has not been thoroughly evaluated.
METHODS
During September-November 2020, 730 adults undergoing SARS-CoV-2 testing at community testing events and homeless shelters in Denver provided self-collected SS and ANS before NPS collection and answered a short survey about symptoms and specimen preference. Specimens were tested for SARS-CoV-2 by means of real-time reverse-transcription polymerase chain reaction (rRT-PCR); viral culture was performed on a subset of specimens positive by rRT-PCR. The sensitivity of SS and ANS for SARS-CoV-2 detection by rRT-PCR was measured against that of NPS. Subgroup analyses included test outcomes by symptom status and culture results.
RESULTS
Sensitivity for SARS-CoV-2 detection by rRT-PCR appeared higher for SS than for ANS (85% vs 80%) and higher among symptomatic participants than among those without symptoms (94% vs 29% for SS; 87% vs 50% for ANS). Among participants with culture-positive SARS-CoV-2 by any specimen type, the sensitivities of SS and ANS by rRT-PCR were 94% and 100%, respectively. SS and ANS were equally preferred by participants; most would undergo NPS collection again despite this method's being the least preferred.
CONCLUSIONS
SS were slightly more sensitive than ANS for SARS-CoV-2 detection with rRT-PCR. With both SS and ANS, SARS-CoV-2 was reliably detected among participants with symptoms. Self-collected SS and ANS offer practical advantages, are preferred by patients, and might be most useful for testing people with coronavirus disease 2019 symptoms.
背景
鼻咽拭子（NPS）常用于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）检测，但可能会令患者感到不适。采集自患者自身的唾液样本（SS）或前鼻拭子（ANS）进行 SARS-CoV-2 检测的侵入性较小，但这些样本类型的敏感性尚未得到彻底评估。
方法
2020 年 9 月至 11 月期间，在丹佛市的社区检测活动和收容所中进行 SARS-CoV-2 检测的 730 名成年人在采集 NPS 之前采集了自身的 SS 和 ANS，并回答了一份有关症状和样本偏好的简短调查问卷。通过实时逆转录聚合酶链反应（rRT-PCR）对样本进行 SARS-CoV-2 检测；对 rRT-PCR 阳性的部分样本进行病毒培养。测量了 SS 和 ANS 检测 rRT-PCR 检测 SARS-CoV-2 的敏感性，并与 NPS 进行了比较。亚组分析包括按症状状态和培养结果进行的检测结果。
结果
rRT-PCR 检测 SS 对 SARS-CoV-2 的敏感性似乎高于 ANS（85%对 80%），且在有症状的参与者中高于无症状参与者（SS 为 94%对 29%；ANS 为 87%对 50%）。在任何样本类型均培养出 SARS-CoV-2 的参与者中，SS 和 ANS 通过 rRT-PCR 的敏感性分别为 94%和 100%。参与者对 SS 和 ANS 的偏好程度相同；尽管 NPS 是最不受欢迎的样本采集方法，但大多数人仍会再次接受 NPS 采集。
结论
SS 用于 rRT-PCR 检测 SARS-CoV-2 的敏感性略高于 ANS。通过 SS 和 ANS，都能可靠地检测出有症状的参与者中的 SARS-CoV-2。采集自患者自身的 SS 和 ANS 具有实际优势，受到患者的青睐，并且对于检测患有 2019 年冠状病毒病症状的患者可能最有用。
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