Comparison of Four Clinical Specimen Types for Detection of Influenza A and B Viruses by Optical Immunoassay (FLU OIA Test) and Cell Culture Methods

Abstract

Although laboratory diagnosis of respiratory viruses has been widely studied, there is a relative insufficiency of literature examining the impact of specimen type on the laboratory diagnosis of influenza A and B. In a clinical study comparing the FLU OIA test with 14-day cell culture, clinical specimens from nasopharyngeal swabs, throat swabs, nasal aspirates, and sputum were obtained from patients experiencing influenza-like symptoms. A total of 404 clinical specimens were collected from 184 patients. Patients were defined as influenza positive if the viral culture of a specimen from any sample site was positive. Patients were defined as influenza negative if the viral cultures of specimens from all sample sites were negative. By this gold standard, culture and FLU OIA test results for each sample type were compared. For each of the four specimen types, the viral culture and FLU OIA test demonstrated equal abilities to detect the presence of influenza A or B virus or viral antigen. Sputum and nasal aspirate samples were the most predictive of influenza virus infection. Throat swabs were the least predictive of influenza virus infection, with both tests failing to detect influenza virus in nearly 50% of the throat samples studied.

Comparison of four nasal sampling methods for the detection of viral pathogens by RT-PCR—A GA2LEN project

“…However, few studies have compared the viral yields from samples taken by two or more sampling methods. Among these, some found nasal aspirates and washes superior to nasal or nasopharyngeal swabs for the detection of respiratory pathogens (Ahluwalia et al, 1987;Covalciuc et al, 1999;Frayha et al, 1989;Heikkinen et al, 2001Heikkinen et al, , 2002. In contrast, other comparative studies obtained adequate viral yields from nasopharyngeal swabs and nasal brushes, for the detection of viruses using immunofluorescent assays and cultures (Barnes et al, 1989;Frayha et al, 1989).…”

“…Confirmation of a viral aetiology for respiratory infections is important both for clinical diagnosis as antiviral treatments are becoming available, and for studying respiratory viruses and their interaction with the respiratory tract (Hayden, 2004). Successful detection of a respiratory virus depends on many variables, including sampling for nasal secretions, which may considerably influence the detection rates (Ahluwalia et al, 1987;Barnes et al, 1989;Covalciuc et al, 1999;Frayha et al, 1989;Heikkinen et al, 2001Heikkinen et al, , 2002Xiang et al, 2002). Several recent studies have attempted to compare different nasal sampling methods (usually no more than two), using mainly detection methods other than PCR, without reaching a clear conclusion (Ahluwalia et al, 1987;Barnes et al, 1989;Covalciuc et al, 1999;Frayha et al, 1989;Heikkinen et al, 2001Heikkinen et al, , 2002Xiang et al, 2002).…”

Difficulty with mumps diagnosis: What is the contribution of mumps mimickers?

“…Secondly, because nasopharyngeal swabs are the ideal specimens for the detection of respiratory viruses, suboptimal sampling with buccal specimens may have lead to an under estimation of the true prevalence of these viruses. 4,14 In addition, since the outbreak specimens were collected using standard viral transport media containing antibiotics, bacterial causes of parotitis could not be evaluated. It is also possible that other viruses not tested could have contributed to the clinical presentation of these patients.…”

The detection of influenza A and B viruses in clinical specimens using a quartz crystal microbalance

“…However, these tests are not rapid and their clinical value is often limited. In the case of influenza viruses, the isolation and identification by culture requires 2-14 days for the diagnosis of an illness whose duration is typically 5-7 days (Covalciuc et al, 1999). Rapid antigen detection tests (≤1 h) are less sensitive and sometimes less specific than culture or molecular methods but, nevertheless, can serve as a guide for appropriate treatment with antiviral agents (Storch, 2003).…”