260. Consistency of influenza A test results across respiratory specimen collection methods using real time reverse transcription polymerase chain reaction
Session: Poster Abstract Session: Diagnostic Microbiology; Novel Molecular Methods
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Although real-time reverse transcription polymerase chain reaction is a well-established method for the detection of influenza infections, prior studies have drawn mixed conclusions regarding the best respiratory specimen to use with this assay. However, nasopharyngeal specimens are generally considered the gold standard.

Methods: In our prospective cohort study of 1781 healthcare personnel, we compared the sensitivity, negative predictive value, and kappa for the detection of influenza infection using nasopharyngeal swabs, oropharyngeal swabs, and nasal swabs collected from 268 participants with febrile acute respiratory illness.

Results: Fifty three influenza A positives were detected, of which 33 (62%) had consistent positive results across the three swab types.

Conclusion: Joint consideration of results from oropharyngeal swabs and nasal swabs performed as well as nasopharyngeal alone as measured by sensitivity and noninferiority analysis. Consistently positive specimens had lower cycle threshold values (indicating higher viral load) and were also associated with older age and shorter interval between illness onset and swab collection.

Sarah Spencer, Ph.D.1, Manjusha Gaglani, MBBS2, Allison Naleway, PhD3,4, Sue Reynolds, MS, MPH5, Sam Bozeman, MPH6, Sarah Ball, MPH, ScD6, Emily Henkle, PhD, MPH4, Jennifer Meece, PhD7, Mary Vandermause, BS, MT8, Lydia Clipper, BSN9 and Mark Thompson, PhD10, (1)Influenza Division/Ncird, Centers for Disease Control and Prevention, Atlanta, GA, (2)Pediatrics, Scott & White Healthcare, Texas A&M Univ HSC COM, Temple, TX, (3)Kaiser Permanente- Northwest, Portland, OR, (4)The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, (5)Influenza Division, Centers of Disease Control and Prevention, Atlanta, GA, (6)Abt Associates, Cambridge, MA, (7)Marshfield Clinic Research Foundation, Marshfield, WI, (8)Marshfield Clinic Res. Fndn., Marshfield, WI, (9)Division of Pediatric Infectious Diseases, Scott & White Healthcare, Temple, TX, (10)Epidemiology and Prevention Branch, Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

S. Spencer, None

M. Gaglani, MedImmune : Investigator, Research grant
Novartis: Investigator, Research grant

A. Naleway, GlaxoSmithKline: Investigator, Research grant

S. Reynolds, None

S. Bozeman, None

S. Ball, None

E. Henkle, None

J. Meece, MedImmune, LLC: Grant Investigator, Research support

M. Vandermause, None

L. Clipper, None

M. Thompson, None

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