Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study

Claire A Woodall; Hannah V Thornton; Emma C  Anderson; Suzanne M Ingle; Peter Muir; Barry Vipond; Denise Longhurst; John P Leeming; Charles R Beck; Alastair D Hay

doi:10.1128/spectrum.00164-21

Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study

Claire A Woodall^*
, Hannah V Thornton
, Emma C Anderson
, Suzanne M Ingle
, Peter Muir
, Barry Vipond
, Denise Longhurst
, John P Leeming
, Charles R Beck
, Alastair D Hay

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

12 Citations (Scopus)

210 Downloads (Pure)

Abstract

Objectives
Respiratory tract infections (RTIs) are ubiquitous in children in the community. A prospective observational study was performed to evaluate the diagnostic performance and quality of at-home parent-collected (PC) nasal and saliva swabs compared to nurse-collected (NC) swabs from children with RTI symptoms.

Methods
Children with RTI symptoms were swabbed at-home on the same day by a parent and nurse. We compared the performance of PC swabs as the test with the NC swabs as the reference for the detection of respiratory pathogen gene targets and quality assessed using a human gene by reverse transcriptase (RT)-PCR.

Results
PC and NC paired nasal and saliva swabs were collected from 91 and 92 children respectively. Performance and inter-rater agreement (Cohen’s kappa, [κ]) of PC vs NC nasal swabs for viruses combined showed sensitivity 91.6% (95% CI, 85.47 - 95.73) and κ, 0.84 (95% CI, 0.79 – 0.88) respectively, and for bacteria combined 91.4% (95% CI, 86.85 - 94.87) and κ, 0.85 (95% CI, 0.80 – 0.89). In saliva samples, viral and bacterial sensitivities were lower at 69.0 % (95% CI, 57.47 - 79.76) and 78.1% (95% CI, 71.60 - 83.76) respectively, as were kappa values at 0.64 (95% CI, 0.53 – 0.72) and 0.70 (95% CI, 0.65 – 0.76). Quality assessment for human biological load (18S rRNA) indicated perfect inter-rater agreement.

Conclusions
At-home PC nasal swabs perform comparably to NC swabs whereas PC saliva swabs lacked sensitivity for the detection of respiratory microbes.

Original language	English
Article number	e00164
Number of pages	38
Journal	Microbiology Spectrum
Volume	9
Issue number	3
Early online date	10 Nov 2021
DOIs	https://doi.org/10.1128/spectrum.00164-21
Publication status	Published - 22 Dec 2021

Bibliographical note

Funding Information:
The study was supported by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Behavioral Science and Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) (grant HPRU-2012-10026). A.D.H. is funded by an NIHR Research Professorship (grant NIHR-RP-02-12-012) and Senior Investigator Award (grant NIHR-200151). C.A.W. is funded in part by the Medical Research Council (MRC) and Wellcome Trust Institutional Strategic Support Fund (grant 204813/Z/16/Z) and by the Daphne Jackson Trust in collaboration with the Elizabeth Blackwell Institute at the University of Bristol. We declare no conflicts of interest.

Publisher Copyright:
© Crown copyright 2021.

Keywords

respiratory tract infection
self-collection

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Woodall, C. A., Thornton, H. V., Anderson, E. C., Ingle, S. M., Muir, P., Vipond, B., Longhurst, D., Leeming, J. P., Beck, C. R., & Hay, A. D. (2021). Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study. Microbiology Spectrum, 9(3), Article e00164. https://doi.org/10.1128/spectrum.00164-21

@article{b73778d670e041bb8bca77a7b6dd73b5,

title = "Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study",

abstract = "Objectives Respiratory tract infections (RTIs) are ubiquitous in children in the community. A prospective observational study was performed to evaluate the diagnostic performance and quality of at-home parent-collected (PC) nasal and saliva swabs compared to nurse-collected (NC) swabs from children with RTI symptoms. Methods Children with RTI symptoms were swabbed at-home on the same day by a parent and nurse. We compared the performance of PC swabs as the test with the NC swabs as the reference for the detection of respiratory pathogen gene targets and quality assessed using a human gene by reverse transcriptase (RT)-PCR. Results PC and NC paired nasal and saliva swabs were collected from 91 and 92 children respectively. Performance and inter-rater agreement (Cohen{\textquoteright}s kappa, [κ]) of PC vs NC nasal swabs for viruses combined showed sensitivity 91.6\% (95\% CI, 85.47 - 95.73) and κ, 0.84 (95\% CI, 0.79 – 0.88) respectively, and for bacteria combined 91.4\% (95\% CI, 86.85 - 94.87) and κ, 0.85 (95\% CI, 0.80 – 0.89). In saliva samples, viral and bacterial sensitivities were lower at 69.0 \% (95\% CI, 57.47 - 79.76) and 78.1\% (95\% CI, 71.60 - 83.76) respectively, as were kappa values at 0.64 (95\% CI, 0.53 – 0.72) and 0.70 (95\% CI, 0.65 – 0.76). Quality assessment for human biological load (18S rRNA) indicated perfect inter-rater agreement. Conclusions At-home PC nasal swabs perform comparably to NC swabs whereas PC saliva swabs lacked sensitivity for the detection of respiratory microbes. ",

keywords = "respiratory tract infection, self-collection",

author = "Woodall, \{Claire A\} and Thornton, \{Hannah V\} and Anderson, \{Emma C\} and Ingle, \{Suzanne M\} and Peter Muir and Barry Vipond and Denise Longhurst and Leeming, \{John P\} and Beck, \{Charles R\} and Hay, \{Alastair D\}",

note = "Funding Information: The study was supported by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Behavioral Science and Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) (grant HPRU-2012-10026). A.D.H. is funded by an NIHR Research Professorship (grant NIHR-RP-02-12-012) and Senior Investigator Award (grant NIHR-200151). C.A.W. is funded in part by the Medical Research Council (MRC) and Wellcome Trust Institutional Strategic Support Fund (grant 204813/Z/16/Z) and by the Daphne Jackson Trust in collaboration with the Elizabeth Blackwell Institute at the University of Bristol. We declare no conflicts of interest. Publisher Copyright: {\textcopyright} Crown copyright 2021.",

year = "2021",

month = dec,

day = "22",

doi = "10.1128/spectrum.00164-21",

language = "English",

volume = "9",

journal = "Microbiology Spectrum",

issn = "2165-0497",

publisher = "American Society for Microbiology",

number = "3",

}

Woodall, CA, Thornton, HV, Anderson, EC , Ingle, SM, Muir, P, Vipond, B, Longhurst, D, Leeming, JP, Beck, CR & Hay, AD 2021, 'Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study', Microbiology Spectrum, vol. 9, no. 3, e00164. https://doi.org/10.1128/spectrum.00164-21

Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study. / Woodall, Claire A; Thornton, Hannah V; Anderson, Emma C et al.
In: Microbiology Spectrum, Vol. 9, No. 3, e00164, 22.12.2021.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms

T2 - a prospective study

AU - Woodall, Claire A

AU - Thornton, Hannah V

AU - Anderson, Emma C

AU - Ingle, Suzanne M

AU - Muir, Peter

AU - Vipond, Barry

AU - Longhurst, Denise

AU - Leeming, John P

AU - Beck, Charles R

AU - Hay, Alastair D

N1 - Funding Information: The study was supported by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Behavioral Science and Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE) (grant HPRU-2012-10026). A.D.H. is funded by an NIHR Research Professorship (grant NIHR-RP-02-12-012) and Senior Investigator Award (grant NIHR-200151). C.A.W. is funded in part by the Medical Research Council (MRC) and Wellcome Trust Institutional Strategic Support Fund (grant 204813/Z/16/Z) and by the Daphne Jackson Trust in collaboration with the Elizabeth Blackwell Institute at the University of Bristol. We declare no conflicts of interest. Publisher Copyright: © Crown copyright 2021.

PY - 2021/12/22

Y1 - 2021/12/22

N2 - Objectives Respiratory tract infections (RTIs) are ubiquitous in children in the community. A prospective observational study was performed to evaluate the diagnostic performance and quality of at-home parent-collected (PC) nasal and saliva swabs compared to nurse-collected (NC) swabs from children with RTI symptoms. Methods Children with RTI symptoms were swabbed at-home on the same day by a parent and nurse. We compared the performance of PC swabs as the test with the NC swabs as the reference for the detection of respiratory pathogen gene targets and quality assessed using a human gene by reverse transcriptase (RT)-PCR. Results PC and NC paired nasal and saliva swabs were collected from 91 and 92 children respectively. Performance and inter-rater agreement (Cohen’s kappa, [κ]) of PC vs NC nasal swabs for viruses combined showed sensitivity 91.6% (95% CI, 85.47 - 95.73) and κ, 0.84 (95% CI, 0.79 – 0.88) respectively, and for bacteria combined 91.4% (95% CI, 86.85 - 94.87) and κ, 0.85 (95% CI, 0.80 – 0.89). In saliva samples, viral and bacterial sensitivities were lower at 69.0 % (95% CI, 57.47 - 79.76) and 78.1% (95% CI, 71.60 - 83.76) respectively, as were kappa values at 0.64 (95% CI, 0.53 – 0.72) and 0.70 (95% CI, 0.65 – 0.76). Quality assessment for human biological load (18S rRNA) indicated perfect inter-rater agreement. Conclusions At-home PC nasal swabs perform comparably to NC swabs whereas PC saliva swabs lacked sensitivity for the detection of respiratory microbes.

AB - Objectives Respiratory tract infections (RTIs) are ubiquitous in children in the community. A prospective observational study was performed to evaluate the diagnostic performance and quality of at-home parent-collected (PC) nasal and saliva swabs compared to nurse-collected (NC) swabs from children with RTI symptoms. Methods Children with RTI symptoms were swabbed at-home on the same day by a parent and nurse. We compared the performance of PC swabs as the test with the NC swabs as the reference for the detection of respiratory pathogen gene targets and quality assessed using a human gene by reverse transcriptase (RT)-PCR. Results PC and NC paired nasal and saliva swabs were collected from 91 and 92 children respectively. Performance and inter-rater agreement (Cohen’s kappa, [κ]) of PC vs NC nasal swabs for viruses combined showed sensitivity 91.6% (95% CI, 85.47 - 95.73) and κ, 0.84 (95% CI, 0.79 – 0.88) respectively, and for bacteria combined 91.4% (95% CI, 86.85 - 94.87) and κ, 0.85 (95% CI, 0.80 – 0.89). In saliva samples, viral and bacterial sensitivities were lower at 69.0 % (95% CI, 57.47 - 79.76) and 78.1% (95% CI, 71.60 - 83.76) respectively, as were kappa values at 0.64 (95% CI, 0.53 – 0.72) and 0.70 (95% CI, 0.65 – 0.76). Quality assessment for human biological load (18S rRNA) indicated perfect inter-rater agreement. Conclusions At-home PC nasal swabs perform comparably to NC swabs whereas PC saliva swabs lacked sensitivity for the detection of respiratory microbes.

KW - respiratory tract infection

KW - self-collection

U2 - 10.1128/spectrum.00164-21

DO - 10.1128/spectrum.00164-21

M3 - Article (Academic Journal)

C2 - 34756077

SN - 2165-0497

VL - 9

JO - Microbiology Spectrum

JF - Microbiology Spectrum

IS - 3

M1 - e00164

ER -

Woodall CA, Thornton HV, Anderson EC , Ingle SM, Muir P, Vipond B et al. Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms: a prospective study. Microbiology Spectrum. 2021 Dec 22;9(3):e00164. Epub 2021 Nov 10. doi: 10.1128/spectrum.00164-21