263. Comparison of Nasopharyngeal and Anterior Nare Swabs for PCR Detection of Respiratory Viruses in Children
Session: Poster Abstract Session: Diagnostic Microbiology; Novel Molecular Methods
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA Nasoph_Anter_Nare_Swabs.pdf (643.3 kB)
  • Background: Respiratory viral infections are the most common reason for medical visits in children. Although standard of care, nasopharyngeal (NP) sampling is invasive, uncomfortable, and may be a barrier to testing young children, especially in outpatient settings. Swabs from the anterior nares (AN) are more easily obtained and comfortable, however, the diagnostic yield and accuracy has not been tested.  The objective of this study was to compare the performance of swabs for respiratory viral PCR collected from the NP and AN of young children with respiratory illness.

    Methods: Febrile or afebrile children < 5 years with signs and symptoms of respiratory infection including one or more of nasal congestion, nasal discharge, cough, sore throat, or wheezing were eligible for enrollment between November 2011-June 2012. Children had both NP and AN sampling performed simultaneously by physicians. Testing for respiratory viral nucleic acid for 17 viruses was performed using the multiplex PCR FilmArray system (BioFire Diagnostics, Inc.).

    Results: Fifty-eight children were enrolled. Respiratory viral nucleic acid was detected in 54/58 children (93%). Viruses detected and concordance between NP and AN samples are shown in the Table. There were 986 opportunities for viral detection (58 children X 17 viruses) for each swab. There were no detections of coronavirus (CoV) 229E or HKU1, influenza (Flu) A (H1, H3, H1-2009), or parainfluenzavirus (PIV) 2, 3, or 4 in either NP or AN samples. NP and AN swabs produced concordant results for 982/986 (99.6%). For discordant results, NP was positive and AN negative in one episode of rhinovirus/enterovirus (RV/EV) detection. AN was positive and NP was negative in two episodes of bocavirus and one episode of RV/EV detection. 

    Children

    Adeno

    Boca

    CoV NL63

    CoV

    OC43

    hMPV

    RV/EV

    Flu B

    PIV 1

    RSV

    NP/AN +

    3

    3

    2

    6

    12

    14

    1

    2

    7

    NP/AN -

    55

    53

    56

    52

    46

    42

    57

    56

    51

    Discordant

    0

    2

    0

    0

    0

    2

    0

    0

    0

    Conclusion: Non-invasive sampling of the anterior nares for respiratory viral PCR performs well when compared with nasopharyngeal sampling and may provide a more acceptable alternative for respiratory viral testing in children.

    Carrie L. Byington, MD1, Wendy Hobson-Rohrer, MD2, Adam L. Hersh, MD, PhD3 and Anne J. Blaschke, MD, PhD1, (1)Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, (2)Pediatrics, University of Utah, Salt Lake City, UT, (3)Pediatrics, University of Utah Health Science Center, Salt Lake City, UT

    Disclosures:

    C. L. Byington, BioFire Diagnostics: Collaborator and Grant Investigator, Grant recipient and Licensing agreement or royalty

    W. Hobson-Rohrer, None

    A. L. Hersh, None

    A. J. Blaschke, BioFire Diagnostics, Inc.: Collaborator, Licensing agreement or royalty

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.