tetano
Editor, Senior Moderator
Infect Drug Resist
. 2024 May 14:17:1903-1910.
doi: 10.2147/IDR.S450991. eCollection 2024. Clinical Performance of Self-Collected Purified Water Gargle for Detection of Influenza a Virus Infection by Real-Time RT-PCR
Guiling Li[SUP] #[/SUP][SUP] 1 2 3 [/SUP], Tianyang Tan[SUP] #[/SUP][SUP] 3 4 5 [/SUP], Luting Chen[SUP] 3 4 5 [/SUP], Jiaqi Bao[SUP] 3 4 5 [/SUP], Dongsheng Han[SUP] 3 4 5 [/SUP], Fei Yu[SUP] 3 4 5 [/SUP]
Affiliations
Purpose: Self-collected specimens are increasingly being used as alternatives to swab-based methods for the detection of respiratory viruses. While saliva is well accepted, gargle specimens are a potential alternative with characteristics that are more favorable for laboratory handling. This study assessed the performance of gargle specimens in the detection of influenza A viruses (IAVs).
Patients and methods: We performed a prospective head-to-head comparison between combined nasopharyngeal and oropharyngeal swabs (NPS&OPS) and purified water gargle (PWG) among adult outpatients with febrile respiratory symptoms to detect IAVs using real-time RT-PCR during two influenza seasons.
Results: During study periods 1 (July 13 to 26, 2022, H3N2 predominated) and 2 (February 25 to March 10, 2023, H1N1 pdm09 predominated), a total of 459 patients were recruited. The overall agreement between the NPS&OPS and PWG was 85.0% (390/459, κ = 0.697), with 88.0% in period 1 and 82.6% in period 2. The detection rate of IAVs in PWG (51.6%, 237/459) was lower than that in NPS&OPS (62.3%, 286/459) (p < 0.0001). The overall sensitivity and specificity were 96.6% (93.7-98.3%) and 100% (97.1-100%) in NPS&OPS and were 80.1% (75.0-84.4%) and 100% (97.1-100%) in PWG, respectively. Among the 227 pairs of concordant positive specimens, cycle threshold (Ct) values were significantly lower in NPS&OPS than in PWG (median Ct values: 24.2, 28.2, p < 0.0001).
Conclusion: Although self-collected PWG specimens offer acceptable performance for IAVs molecular testing, NPS&OPS remain a reliable option. Given the convenience of collection, nonviscous gargles are recommended for viral detection during emergencies or under specific conditions.
Keywords: detection; gargle; influenza A virus; nasopharyngeal swab; oropharyngeal swab; rRT-PCR.
. 2024 May 14:17:1903-1910.
doi: 10.2147/IDR.S450991. eCollection 2024. Clinical Performance of Self-Collected Purified Water Gargle for Detection of Influenza a Virus Infection by Real-Time RT-PCR
Guiling Li[SUP] #[/SUP][SUP] 1 2 3 [/SUP], Tianyang Tan[SUP] #[/SUP][SUP] 3 4 5 [/SUP], Luting Chen[SUP] 3 4 5 [/SUP], Jiaqi Bao[SUP] 3 4 5 [/SUP], Dongsheng Han[SUP] 3 4 5 [/SUP], Fei Yu[SUP] 3 4 5 [/SUP]
Affiliations
- PMID: 38766678
- PMCID: PMC11102144
- DOI: 10.2147/IDR.S450991
Purpose: Self-collected specimens are increasingly being used as alternatives to swab-based methods for the detection of respiratory viruses. While saliva is well accepted, gargle specimens are a potential alternative with characteristics that are more favorable for laboratory handling. This study assessed the performance of gargle specimens in the detection of influenza A viruses (IAVs).
Patients and methods: We performed a prospective head-to-head comparison between combined nasopharyngeal and oropharyngeal swabs (NPS&OPS) and purified water gargle (PWG) among adult outpatients with febrile respiratory symptoms to detect IAVs using real-time RT-PCR during two influenza seasons.
Results: During study periods 1 (July 13 to 26, 2022, H3N2 predominated) and 2 (February 25 to March 10, 2023, H1N1 pdm09 predominated), a total of 459 patients were recruited. The overall agreement between the NPS&OPS and PWG was 85.0% (390/459, κ = 0.697), with 88.0% in period 1 and 82.6% in period 2. The detection rate of IAVs in PWG (51.6%, 237/459) was lower than that in NPS&OPS (62.3%, 286/459) (p < 0.0001). The overall sensitivity and specificity were 96.6% (93.7-98.3%) and 100% (97.1-100%) in NPS&OPS and were 80.1% (75.0-84.4%) and 100% (97.1-100%) in PWG, respectively. Among the 227 pairs of concordant positive specimens, cycle threshold (Ct) values were significantly lower in NPS&OPS than in PWG (median Ct values: 24.2, 28.2, p < 0.0001).
Conclusion: Although self-collected PWG specimens offer acceptable performance for IAVs molecular testing, NPS&OPS remain a reliable option. Given the convenience of collection, nonviscous gargles are recommended for viral detection during emergencies or under specific conditions.
Keywords: detection; gargle; influenza A virus; nasopharyngeal swab; oropharyngeal swab; rRT-PCR.