Use of an innovative and non-invasive device for virologic sampling of cough aerosols in patients with community and hospital acquired pneumonia: a pilot study

Patrucco, Filippo; Gavelli, Francesco; Ravanini, Paolo; Daverio, Matteo; Statti, Giulia; Castello, Luigi Mario; Andreoni, Stefano; Balbo, Piero Emilio

doi:10.1088/1752-7163/aaf010

Cited by 28 publications

(8 citation statements)

References 59 publications

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“…Various studies conducted during flu seasons have shown the feasibility of detecting viruses in exhaled breath condensates using commercially available bio-samplers and cough sampling systems [9][10][11]. Even face mask sampling-a low-cost method-has also proved to be effective for analyzing exhaled/expelled respiratory particles and detecting respiratory pathogens like the influenza virus [12,13].…”

Section: Introductionmentioning

confidence: 99%

Non-invasive adapted N-95 mask sampling captures variation in viral particles expelled by COVID-19 patients: Implications in understanding SARS-CoV2 transmission

et al. 2021

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Infectious respiratory particles expelled by SARS-CoV-2 positive patients are attributed to be the key driver of COVID-19 transmission. Understanding how and by whom the virus is transmitted can help implement better disease control strategies. Here we have described the use of a noninvasive mask sampling method to detect and quantify SARS-CoV-2 RNA in respiratory particles expelled by COVID-19 patients and discussed its relationship to transmission risk. Respiratory particles of 31 symptomatic SARS-CoV-2 positive patients and 31 asymptomatic healthy volunteers were captured on N-95 masks layered with a gelatin membrane in a 30-minute process that involved talking/reading, coughing, and tidal breathing. SARS-CoV-2 viral RNA was detected and quantified using rRT-PCR in the mask and in concomitantly collected nasopharyngeal swab (NPS) samples. The data were analyzed with respect to patient demographics and clinical presentation. Thirteen of 31(41.9%) patients showed SARS-COV-2 positivity in both the mask and NPS samples, while 16 patients were mask negative but NPS positive. Two patients were both mask and NPS negative. All healthy volunteers except one were mask and NPS negative. The mask positive patients had significantly lower NPS Ct value (26) compared to mask negative patients (30.5) and were more likely to be rapid antigen test positive. The mask positive patients could be further grouped into low emitters (expelling <100 viral copies) and high emitters (expelling >1000 viral copies). The study presents evidence for variation in emission of SARS-CoV-2 virus particles by COVID-19 patients reflecting differences in infectivity and transmission risk among individuals. The results conform to reported secondary infection rates and transmission and also suggest that mask sampling could be explored as an effective tool to assess individual transmission risks, at different time points and during different activities.

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Section: Introductionmentioning

confidence: 99%

Non-invasive adapted N-95 mask sampling captures variation in viral particles expelled by COVID-19 patients: Implications in understanding SARS-CoV2 transmission

et al. 2021

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“…However, contamination with bacteria from the upper airways (Streptococcus mitis) was found in 93% of sputum samples versus 0% in the cough samples suggesting sampling of the lower airways with their device. Patrucco et al investigated the PneumoniaCheck TM in a small cohort of pneumonia patients where they found a good correlation of the results with BAL samples for non-herpes viruses [23].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive diagnostics of pathogenic bacteria using a breath sampler in children with cystic fibrosis

et al. 2022

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Cystic fibrosis is a common autosomal recessive disease causing thick, viscous secretions leading to pulmonary infections with pathogenic bacteria. As part of routine patient care, colonization and infection with these bacteria is monitored with cough swab or sputum cultures and sometimes bronchoalveolar lavage. In this cross-sectional proof-of-concept study in a cohort of CF patients we collected swabs or sputa and exhaled breath samples with the Modular Breath Sampler (MBS), a newly developed two-way non-rebreathing sampling device. Pathogen specific polymerase chain reactions (PCRs) were performed on the MBS samples and compared with the results obtained with conventional diagnostics (i.e. culturing of swabs and sputa). A control group of stable asthma patients was used as negative control for the MBS measurements. The pathogens detected using MBS and conventional culturing differed: Staphylococcus aureus was found more often in swab or sputum samples whereas Pseudomonas aeruginosa and Streptococcus pneumoniae were found more often in MBS samples. We hypothesize that this is due to sampling of different compartments, MBS samples are derived from the lower respiratory tract while cultures from cough swabs and sputa are dominated by pathogens residing in the upper respiratory tract. Another important difference is the readout, i.e. culture versus PCR. The majority of CF patients in whom Pseudomonas aeruginosa was found did not have recent positive cultures suggesting higher sensitivity of MBS-based than conventional diagnostics. The majority of parents / patients found the MBS easy to use and less of a burden than respiratory sampling.

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“…Nevertheless, up to now only few and no specific data are present in the literature regarding the prevalence of mycotic infections among patients who are hospitalized for suspected SARS-CoV-2 pulmonary infection with pulmonary infiltrates, outside the intensive care unit (ICU). Although in many clinical situations a non-invasive approach can be considered sufficient for the diagnostic work-up [23], some studies have investigated the role of bronchoscopy for diagnosis in COVID-19 patients: most of them confirmed the limited place of BAL in SARS-CoV-2 diagnosis, suggesting a role in resolving diagnostic complex cases [7]. In these studies, mycotic infections represent a relevant part of pathogens isolated on BAL: in the paper of Barberi et al among 166 negative BAL for COVID-19, a mycotic agent was identified 38 times (22.9%), with Aspergillus fumigatus and Candida spp being the most isolated ones [24].…”

Section: Discussionmentioning

confidence: 99%

Mycotic infection prevalence among patients undergoing bronchoalveolar lavage with search of SARS-CoV-2 after two negative nasopharyngeal swabs

Patrucco¹,

Airoldi²,

Falaschi³

et al. 2021

J. Breath Res.

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The evidence that severe coronavirus disease 2019 (COVID-19) is a risk factor for development of mycotic respiratory infection with an increased mortality is rising. Immunosuppressed are among the most susceptible patients and Aspergillus species is the most feared superinfection. In this study we evaluated mycotic isolation prevalence on bronchoalveolar lavage (BAL) of patients who underwent bronchoscopy in search of severe acute respiratory coronavirus 2 (SARS-CoV-2) RNA. Moreover, we described the clinical characteristics and main outcomes of these patients. We included 118 patients, 35.9% of them were immunosuppressed for different reasons: in 23.7% we isolated SARS-CoV-2 RNA, in 33.1% we identified at least one mycotic agent and both in 15.4%. On BAL we observed in three cases Aspergillus spp, in six cases Pneumocystis and in 32 Candida spp. The prevalence of significant mold infection was 29.3% and 70.7% of cases were false positive or clinically irrelevant infections. In-hospital mortality of patients with fungal infection was 15.3%. The most frequent computed tomography (CT) pattern, evaluated with the Radiological Society of North America consensus statement, among patients with a mycotic pulmonary infection was the atypical one (p < 0.0001). Mycotic isolation on BAL may be interpreted as an innocent bystander, but its identification could influence the prognosis of patients, especially in those who need invasive investigations during the COVID-19 pandemic; BAL plays a fundamental role in resolving clinical complex cases, especially in immunosuppressed patients independently from radiological features, without limiting its role in ruling out SARS-CoV-2 infection.

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Use of an innovative and non-invasive device for virologic sampling of cough aerosols in patients with community and hospital acquired pneumonia: a pilot study

Cited by 28 publications

References 59 publications

Non-invasive adapted N-95 mask sampling captures variation in viral particles expelled by COVID-19 patients: Implications in understanding SARS-CoV2 transmission

Non-invasive adapted N-95 mask sampling captures variation in viral particles expelled by COVID-19 patients: Implications in understanding SARS-CoV2 transmission

Non-invasive diagnostics of pathogenic bacteria using a breath sampler in children with cystic fibrosis

Mycotic infection prevalence among patients undergoing bronchoalveolar lavage with search of SARS-CoV-2 after two negative nasopharyngeal swabs

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