Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review

Nasal pathogen detection sensitivities can be as low as 70% despite advances in molecular diagnostics. This may be linked to the choice of sampling method. A diagnostic test accuracy review for sensitivity was undertaken to compare sensitivity of swabbing to the nasopharynx and extracting nasal aspi...

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Autores principales:	Matthew F. Flynn, Martin Kelly, James S. G. Dooley
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	respiratory virus bacteria nasopharyngeal microbiome infection Medicine R
Acceso en línea:	https://doaj.org/article/371503f9ced84c418e0156dd0f10a929
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spelling	oai:doaj.org-article:371503f9ced84c418e0156dd0f10a9292021-11-25T18:38:52ZNasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review10.3390/pathogens101115152076-0817https://doaj.org/article/371503f9ced84c418e0156dd0f10a9292021-11-01T00:00:00Zhttps://www.mdpi.com/2076-0817/10/11/1515https://doaj.org/toc/2076-0817Nasal pathogen detection sensitivities can be as low as 70% despite advances in molecular diagnostics. This may be linked to the choice of sampling method. A diagnostic test accuracy review for sensitivity was undertaken to compare sensitivity of swabbing to the nasopharynx and extracting nasal aspirates, using the PRISMA protocol, Cochrane rapid review methodology, and QUADAS-2 risk of bias tools, with meta-analysis of included studies. Sensitivities were calculated by a consensus standard of positivity by either method as the ‘gold standard.’ Insufficient sampling methodology, cross sectional study designs, and studies pooling samples across anatomical sites were excluded. Of 13 subsequently eligible studies, 8 had ‘high’ risk of bias, and 5 had ‘high’ applicability concerns. There were no statistical differences in overall sensitivities between collection methods for eight different viruses, and this did not differ with use of PCR, immunofluorescence, or culture. In one study alone, Influenza H1N1(2009) favored nasopharyngeal swabs, with aspirates having 93.3% of the sensitivity of swabs (<i>p</i> > 0.001). Similarly equivocal sensitivities were noted in reports detecting bacteria. The chain of sampling, from anatomical site to laboratory results, features different potential foci along which sensitivity may be lost. A fair body of evidence exists that use of a different sampling method will not yield more respiratory pathogens.Matthew F. FlynnMartin KellyJames S. G. DooleyMDPI AGarticlerespiratoryvirusbacterianasopharyngealmicrobiomeinfectionMedicineRENPathogens, Vol 10, Iss 1515, p 1515 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	respiratory virus bacteria nasopharyngeal microbiome infection Medicine R
spellingShingle	respiratory virus bacteria nasopharyngeal microbiome infection Medicine R Matthew F. Flynn Martin Kelly James S. G. Dooley Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review
description	Nasal pathogen detection sensitivities can be as low as 70% despite advances in molecular diagnostics. This may be linked to the choice of sampling method. A diagnostic test accuracy review for sensitivity was undertaken to compare sensitivity of swabbing to the nasopharynx and extracting nasal aspirates, using the PRISMA protocol, Cochrane rapid review methodology, and QUADAS-2 risk of bias tools, with meta-analysis of included studies. Sensitivities were calculated by a consensus standard of positivity by either method as the ‘gold standard.’ Insufficient sampling methodology, cross sectional study designs, and studies pooling samples across anatomical sites were excluded. Of 13 subsequently eligible studies, 8 had ‘high’ risk of bias, and 5 had ‘high’ applicability concerns. There were no statistical differences in overall sensitivities between collection methods for eight different viruses, and this did not differ with use of PCR, immunofluorescence, or culture. In one study alone, Influenza H1N1(2009) favored nasopharyngeal swabs, with aspirates having 93.3% of the sensitivity of swabs (<i>p</i> > 0.001). Similarly equivocal sensitivities were noted in reports detecting bacteria. The chain of sampling, from anatomical site to laboratory results, features different potential foci along which sensitivity may be lost. A fair body of evidence exists that use of a different sampling method will not yield more respiratory pathogens.
format	article
author	Matthew F. Flynn Martin Kelly James S. G. Dooley
author_facet	Matthew F. Flynn Martin Kelly James S. G. Dooley
author_sort	Matthew F. Flynn
title	Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review
title_short	Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review
title_full	Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review
title_fullStr	Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review
title_full_unstemmed	Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review
title_sort	nasopharyngeal swabs vs. nasal aspirates for respiratory virus detection: a systematic review
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/371503f9ced84c418e0156dd0f10a929
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Nasopharyngeal Swabs vs. Nasal Aspirates for Respiratory Virus Detection: A Systematic Review

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