Comparison between nasopharyngeal swab and nasal wash, using culture and PCR, in the detection of potential respiratory pathogens

Gritzfeld, Jenna F.; Roberts, Paul C.; Roche, L; Batrawy, Sherouk El; Gordon, Stephen B.

doi:10.1186/1756-0500-4-122

Cited by 48 publications

(45 citation statements)

References 12 publications

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“…NW samples were processed as previously described (20). Volunteers in whom 6B pneumococci were detected by classical microbiology from NW samples collected on any of the visits were defined as carriers.…”

Section: Nasal Washing and Determination Of Carriagementioning

confidence: 99%

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Controlled Human Infection and Rechallenge with Streptococcus pneumoniae Reveals the Protective Efficacy of Carriage in Healthy Adults

Ferreira

Neill

Bangert

et al. 2013

Am J Respir Crit Care Med

170

250

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Rationale: The immunological and protective role of pneumococcal carriage in healthy adults is not known, but high rates of disease and death in the elderly are associated with low carriage prevalence. Objectives: We employed an experimental human pneumococcal carriage model to investigate the immunizing effect of a single carriage episode. Methods: Seventy healthy adults were challenged, and of those with carriage, 10 were rechallenged intranasally with live 6B Streptococcus pneumoniae up to 11 months after clearance of the first carriage episode. Serum and nasal wash antibody responses were measured before and after each challenge. Measurements and Main Results: A total of 29 subjects were experimentally colonized. No subjects were colonized by experimental rechallenge, demonstrating the protective effect of initial carriage against subsequent infection. Carriage increased both mucosal and serum IgG levels to pneumococcal proteins and polysaccharide, resulting in a fourfold increase in opsonophagocytic activity. Importantly, passive transfer of postcarriage sera from colonized subjects conferred 70% protection against lethal challenge by a heterologous strain in a murine model of invasive pneumococcal pneumonia. These levels were significantly higher than the protection conferred by either precarriage sera (30%) or saline (10%). Conclusions: Experimental human carriage resulted in mucosal and systemic immunological responses that conferred protection against recolonization and invasive pneumococcal disease. These data suggest that mucosal pneumococcal vaccination strategies may be important for vulnerable patient groups, particularly the elderly, who do not sustain carriage.

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Section: Nasal Washing and Determination Of Carriagementioning

confidence: 99%

“…No difference in the geometric mean antibody titer (GMT) was observed when prechallenge (baseline) samples of carriage-positive volunteers and carriagenegative volunteers were compared (P ¼ 0. 20 …”

Section: Carriage Increases Opsonophagocytic Activity Of Antibodies Imentioning

confidence: 99%

Controlled Human Infection and Rechallenge with Streptococcus pneumoniae Reveals the Protective Efficacy of Carriage in Healthy Adults

Ferreira

Neill

Bangert

et al. 2013

Am J Respir Crit Care Med

170

250

View full text Add to dashboard Cite

show abstract

“…Recently, Jeoung et al (2013) used both NS and whole blood samples for CIRDC virus detection, but found that only CDV (and not CIV and CRCoV) could be detected from the whole blood samples [10]. Correspondingly, respiratory swabs have been reported to be appropriate samples for the detection of respiratory pathogens [9, 16]. Thus, NS and OS served as appropriate sample sources in our study due to their ease of and non-invasive sampling nature and that they lie on the viral shedding routes.…”

Section: Discussionmentioning

confidence: 99%

Development and application of multiplex PCR assays for detection of virus-induced respiratory disease complex in dogs

Piewbang

Rungsipipat

Poovorawan

et al. 2016

The Journal of Veterinary Medical Science

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Canine infectious respiratory disease complex (CIRDC) viruses have been detected in dogs with respiratory illness. Canine influenza virus (CIV), canine parainfluenza virus (CPIV), canine distemper virus (CDV), canine respiratory coronavirus (CRCoV), canine adenovirus type 2 (CAdV-2) and canine herpesvirus 1 (CaHV-1), are all associated with the CIRDC. To allow diagnosis, two conventional multiplex polymerase chain reactions (PCR) were developed to simultaneously identify four RNA and two DNA viruses associated with CIRDC. The two multiplex PCR assays were then validated on 102 respiratory samples collected from 51 dogs with respiratory illness by sensitivity and specificity determination in comparison to conventional simplex PCR and a rapid three-antigen test kit. All six viruses were detected in either individual or multiple infections. The developed multiplex PCR assays had a >87% sensitivity and 100% specificity compared to their simplex counterpart. Compared to the three-antigen test kit, the multiplex PCR assays yielded 100% sensitivity and more than 83% specificity for detection of CAdV-2 and CDV, but not for CIV. Therefore, the developed multiplex PCR modalities were able to simultaneously diagnose a panel of CIRDC viruses and facilitated specimen collection through being suitable for use of nasal or oral samples.

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“…Our method of carriage assessment is a nasal wash, chosen because a recent study 10 showed that 91% of volunteers found nasal wash to be more comfortable than nasopharyngeal swab; the nasal wash was also more likely to detect pathogens using microbiological culture. Microbial flora recovered on blood agar plates inoculated with NW can be variable and difficult to read.…”

Section: Representative Resultsmentioning

confidence: 99%

Experimental human pneumococcal carriage

Collins¹

2016

http://isrctn.com/

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Experimental human pneumococcal carriage (EHPC) is scientifically important because nasopharyngeal carriage of Streptococcus pneumoniae is both the major source of transmission and the prerequisite of invasive disease. A model of carriage will allow accurate determination of the immunological correlates of protection, the immunizing effect of carriage and the effect of host pressure on the pathogen in the nasopharyngeal niche. Further, methods of carriage detection useful in epidemiologic studies, including vaccine studies, can be compared. AimWe aim to develop an EHPC platform that is a safe and useful reproducible method that could be used to down-select candidate novel pneumococcal vaccines with prevention of carriage as a surrogate of vaccine induced immunity. It will work towards testing of candidate vaccines and descriptions of the mechanisms underlying EHPC and vaccine protection from carriage 1 . Current conjugate vaccines against pneumococcus protect children from invasive disease although new vaccines are urgently needed as the current vaccine does not confer optimal protection against non-bacteraemic pneumonia and there has been evidence of serotype replacement with non-vaccine serotypes [2][3][4] . MethodWe inoculate with S. pneumoniae suspended in 100 μl of saline. Safety is a major factor in the development of the EHPC model and is achieved through intensive volunteer screening and monitoring. A safety committee consisting of clinicians and scientists that are independent from the study provides objective feedback on a weekly basis.The bacterial inoculum is standardized and requires that no animal products are inoculated into volunteers (vegetable-based media and saline). . Detecting pneumococcal carriage is enhanced by a high volume (ideally >10 ml) nasal wash that is relatively mucus free. This protocol will deal with the most important parts of the protocol in turn. These are (a) volunteer selection, (b) pneumococcal inoculum preparation, (c) inoculation, (d) follow-up and (e) carriage detection. ResultsOur current protocol has been safe in over 100 volunteers at a range of doses using two different bacterial serotypes 6 . A dose ranging study using S. pneumoniae 6B and 23F is currently being conducted to determine the optimal inoculation dose for 50% carriage. A predicted 50% rate of carriage will allow the EHPC model to have high sensitivity for vaccine efficacy with small study numbers. Video LinkThe video component of this article can be found at

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Comparison between nasopharyngeal swab and nasal wash, using culture and PCR, in the detection of potential respiratory pathogens

Cited by 48 publications

References 12 publications

Controlled Human Infection and Rechallenge with Streptococcus pneumoniae Reveals the Protective Efficacy of Carriage in Healthy Adults

Controlled Human Infection and Rechallenge with Streptococcus pneumoniae Reveals the Protective Efficacy of Carriage in Healthy Adults

Development and application of multiplex PCR assays for detection of virus-induced respiratory disease complex in dogs

Experimental human pneumococcal carriage

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