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Comparative Study
. 2012 Nov;10(4):215-8.
doi: 10.3121/cmr.2012.1084. Epub 2012 Jun 21.

Comparison of nasal and nasopharyngeal swabs for influenza detection in adults

Stephanie A Irving  1 , Mary F Vandermause, David K Shay, Edward A Belongia
Affiliations
Comparative Study

Comparison of nasal and nasopharyngeal swabs for influenza detection in adults

Stephanie A Irving et al. Clin Med Res. 2012 Nov.

Abstract

Objective: Examine differences in the detection of influenza by specimen and test type using paired nasal and nasopharyngeal swabs.

Design: Prospective study

Setting: Enrollment took place between January and March 2007 in a central Wisconsin population.

Participants: Adult patients were screened and enrolled by trained research coordinators following medical encounters for acute respiratory illnesses of <10 days duration.

Methods: Paired nasal and nasopharyngeal swabs were collected from consenting patients and tested by both real-time reverse transcriptase polymerase chain reaction (rRT-PCR) and viral culture. A composite measure of positivity was used as the gold standard; cases included any positive result by rRT-PCR or viral culture from either specimen type.

Results: Paired samples were collected from 240 adults; 33 (14%) individuals tested positive for influenza by rRT-PCR. Using rRT-PCR, the sensitivity of the nasal swab was 89% (95% CI, 78%-99%) and the sensitivity of the nasopharyngeal swab was 94% (95% CI, 87%-100%), compared to a composite gold standard.

Conclusion: Test sensitivity did not vary significantly by swab type when using a highly sensitive molecular diagnostic test, but power was limited to detect modest differences.

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