tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2018 Jun 12. pii: S1198-743X(18)30468-3. doi: 10.1016/j.cmi.2018.06.009. [Epub ahead of print]
[h=1]Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study.[/h] To KK[SUP]1[/SUP], Yip CC[SUP]2[/SUP], Lai CY[SUP]2[/SUP], Wong CK[SUP]3[/SUP], Ho DT[SUP]4[/SUP], Pang PK[SUP]4[/SUP], Ng AC[SUP]4[/SUP], Leung KH[SUP]5[/SUP], Poon RW[SUP]2[/SUP], Chan KH[SUP]4[/SUP], Cheng VC[SUP]2[/SUP], Hung IF[SUP]6[/SUP], Yuen KY[SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] Automated point-of-care molecular assays have greatly shortened the turnaround time of respiratory virus testing. One of the major bottlenecks now lies at the step of the specimen collection especially in a busy clinical setting. Saliva is a convenient specimen type which can be provided easily from adult patients. This study assessed the diagnostic validity, specimen collection time, and cost associated with the use of saliva.
[h=4]METHODS:[/h] This was a prospective diagnostic validity study comparing the detection rate of respiratory viruses between saliva and nasopharyngeal aspirate (NPA) among adult hospitalized patients using Xpert[SUP]?[/SUP] Xpress Flu/RSV. The cost and time associated with the collection of saliva and nasopharyngeal specimens were also estimated.
[h=4]RESULTS:[/h] Between July and October 2017, 214 patients were recruited. The overall agreement between saliva and NPA were 93.3% (196/210, κ 0.851, 95% CI 0.776-0.926). There was no significant difference in the detection rate of respiratory viruses between saliva and NPA (32.9% [69/210] vs 35.7% [75/210]; P=0.146). The overall sensitivity and specificity were 90.8% (81.9-96.2%) and 100% (97.3-100%), respectively, for saliva, and were 96.1% (88.9-99.2%) and 98.5% (94.7-99.8%), respectively, for NPA. The time and cost associated with the collection of saliva were 2.26-fold and 2.59-fold lower, respectively, than those of NPA.
[h=4]CONCLUSIONS:[/h] Saliva specimen has high sensitivity and specificity in the detection of respiratory viruses by an automated multiplex Clinical Laboratory Improvement Amendments (CLIA)-waived point-of-care molecular assay when compared with that of NPA. The use of saliva also reduces the time and cost associated with specimen collection.
Copyright ? 2018. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Automated; Cost; Influenza virus; Nasopharyngeal; Point-of-care testing; Respiratory Syncytial virus; Saliva
PMID: 29906597 DOI: 10.1016/j.cmi.2018.06.009
[h=1]Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study.[/h] To KK[SUP]1[/SUP], Yip CC[SUP]2[/SUP], Lai CY[SUP]2[/SUP], Wong CK[SUP]3[/SUP], Ho DT[SUP]4[/SUP], Pang PK[SUP]4[/SUP], Ng AC[SUP]4[/SUP], Leung KH[SUP]5[/SUP], Poon RW[SUP]2[/SUP], Chan KH[SUP]4[/SUP], Cheng VC[SUP]2[/SUP], Hung IF[SUP]6[/SUP], Yuen KY[SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] Automated point-of-care molecular assays have greatly shortened the turnaround time of respiratory virus testing. One of the major bottlenecks now lies at the step of the specimen collection especially in a busy clinical setting. Saliva is a convenient specimen type which can be provided easily from adult patients. This study assessed the diagnostic validity, specimen collection time, and cost associated with the use of saliva.
[h=4]METHODS:[/h] This was a prospective diagnostic validity study comparing the detection rate of respiratory viruses between saliva and nasopharyngeal aspirate (NPA) among adult hospitalized patients using Xpert[SUP]?[/SUP] Xpress Flu/RSV. The cost and time associated with the collection of saliva and nasopharyngeal specimens were also estimated.
[h=4]RESULTS:[/h] Between July and October 2017, 214 patients were recruited. The overall agreement between saliva and NPA were 93.3% (196/210, κ 0.851, 95% CI 0.776-0.926). There was no significant difference in the detection rate of respiratory viruses between saliva and NPA (32.9% [69/210] vs 35.7% [75/210]; P=0.146). The overall sensitivity and specificity were 90.8% (81.9-96.2%) and 100% (97.3-100%), respectively, for saliva, and were 96.1% (88.9-99.2%) and 98.5% (94.7-99.8%), respectively, for NPA. The time and cost associated with the collection of saliva were 2.26-fold and 2.59-fold lower, respectively, than those of NPA.
[h=4]CONCLUSIONS:[/h] Saliva specimen has high sensitivity and specificity in the detection of respiratory viruses by an automated multiplex Clinical Laboratory Improvement Amendments (CLIA)-waived point-of-care molecular assay when compared with that of NPA. The use of saliva also reduces the time and cost associated with specimen collection.
Copyright ? 2018. Published by Elsevier Ltd.
[h=4]KEYWORDS:[/h] Automated; Cost; Influenza virus; Nasopharyngeal; Point-of-care testing; Respiratory Syncytial virus; Saliva
PMID: 29906597 DOI: 10.1016/j.cmi.2018.06.009