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Head & Neck Jun 2020Performing a proper nasal and oropharyngeal swab procedure is essential in the screening of COVID-19 infection. The video illustration of nasal and oropharyngeal swab is...
Performing a proper nasal and oropharyngeal swab procedure is essential in the screening of COVID-19 infection. The video illustration of nasal and oropharyngeal swab is presented (Video S1). To correctly perform the nasopharyngeal swab, the patient must be seated comfortably with the back of their head against the headrest. The swab is inserted in the nose horizontally, along an imaginary line between the nostril and the ear. Oropharyngeal sampling is easier to perform. The swab is directed toward the rear wall of the oropharynx and it is rotated a few times before removal. After taking the sample, it is necessary to insert both swabs in the same tube, breaking the rod with one swift and controlled movement. Finally, carefully reset the cap. It appears to be extremely important to properly collect nasopharyngeal and oropharyngeal swabs in order to minimize the false negative rate among COVID-19 positive patients.
Topics: Betacoronavirus; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Coronavirus Infections; Humans; Nasal Cavity; Oropharynx; Pandemics; Pneumonia, Viral; SARS-CoV-2; Specimen Handling
PubMed: 32352180
DOI: 10.1002/hed.26212 -
Antimicrobial Agents and Chemotherapy 2014Pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with poor outcomes and frequently merits empirical antibiotic consideration despite its...
Pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with poor outcomes and frequently merits empirical antibiotic consideration despite its relatively low incidence. Nasal colonization with MRSA is associated with clinical MRSA infection and can be reliably detected using the nasal swab PCR assay. In this study, we evaluated the performance of the nasal swab MRSA PCR in predicting MRSA pneumonia. A retrospective cohort study was performed in a tertiary care center from January 2009 to July 2011. All patients with confirmed pneumonia who had both a nasal swab MRSA PCR test and a bacterial culture within predefined time intervals were included in the study. These data were used to calculate sensitivity, specificity, positive predictive value, and negative predictive value for clinically confirmed MRSA pneumonia. Four hundred thirty-five patients met inclusion criteria. The majority of cases were classified as either health care-associated (HCAP) (54.7%) or community-acquired (CAP) (34%) pneumonia. MRSA nasal PCR was positive in 62 (14.3%) cases. MRSA pneumonia was confirmed by culture in 25 (5.7%) cases. The MRSA PCR assay demonstrated 88.0% sensitivity and 90.1% specificity, with a positive predictive value of 35.4% and a negative predictive value of 99.2%. In patients with pneumonia, the MRSA PCR nasal swab has a poor positive predictive value but an excellent negative predictive value for MRSA pneumonia in populations with low MRSA pneumonia incidence. In cases of culture-negative pneumonia where initial empirical antibiotics include an MRSA-active agent, a negative MRSA PCR swab can be reasonably used to guide antibiotic de-escalation.
Topics: Aged; Anti-Bacterial Agents; Drug Dosage Calculations; Female; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Nasal Cavity; Pneumonia, Staphylococcal; Polymerase Chain Reaction; Predictive Value of Tests; Retrospective Studies
PubMed: 24277023
DOI: 10.1128/AAC.01805-13 -
Clinical Oral Investigations Feb 2022The presence of SARS-CoV-2 virus in the saliva of patients infected with COVID-19 has been confirmed by several studies. However, the use of saliva for the diagnosis of...
OBJECTIVES
The presence of SARS-CoV-2 virus in the saliva of patients infected with COVID-19 has been confirmed by several studies. However, the use of saliva for the diagnosis of COVID-19 remains limited, because of the discrepancies in the results, which might be due to using different saliva sampling methods. The purpose of this study was to compare the consistency of SARS-CoV-2 detection using two different saliva sampling methods (oral swab and unstimulated saliva) to that of the standard nasopharyngeal swab.
METHODS
Fifty-five subjects were recruited from a pool of COVID-19 inpatient at the Hospital Israelita Albert Einstein (HIAE), Brazil. Nasopharyngeal swab, oral swab, and self-collected unstimulated saliva samples were examined for SARS-CoV-2 using RT-PCR.
RESULTS
Self-collected unstimulated saliva demonstrated 87.3% agreement in the detection of SARS-CoV-2 virus as compared with the nasopharyngeal swab, while oral swab displayed 65.9% agreement when compared to nasopharyngeal swab and 73% when compared to self-collected unstimulated saliva.
CONCLUSION
Unstimulated self-collected saliva samples have shown a higher agreement with the nasopharyngeal swab samples for SARS-COV-2 detection than that obtained when using oral swab samples.
CLINICAL RELEVANCE
This study compares the accuracy of COVID-19 test using different saliva sampling methods to that of nasopharyngeal swab. Given the need for a simple self-applied test that can be performed at home, our findings support the efficacy of self-collected unstimulated saliva samples in the diagnosis of SARS-CoV-2 infection, alleviating the demands for swab supplies, personal protective equipment, and healthcare personnel.
Topics: COVID-19; Humans; Nasopharynx; SARS-CoV-2; Saliva; Specimen Handling
PubMed: 34387730
DOI: 10.1007/s00784-021-04129-7 -
International Journal of Molecular... Dec 2022Collection and interpretation of "touch DNA" from crime scenes represent crucial steps during criminal investigations, with clear consequences in courtrooms. Although... (Review)
Review
Collection and interpretation of "touch DNA" from crime scenes represent crucial steps during criminal investigations, with clear consequences in courtrooms. Although the main aspects of this type of evidence have been extensively studied, some controversial issues remain. For instance, there is no conclusive evidence indicating which sampling method results in the highest rate of biological material recovery. Thus, this study aimed to describe the actual considerations on touch DNA and to compare three different sampling procedures, which were "single-swab", "double-swab", and "other methods" (i.e., cutting out, adhesive tape, FTA paper scraping), based on the experimental results published in the recent literature. The data analysis performed shows the higher efficiency of the single-swab method in DNA recovery in a wide variety of experimental settings. On the contrary, the double-swab technique and other methods do not seem to improve recovery rates. Despite the apparent discrepancy with previous research, these results underline certain limitations inherent to the sampling procedures investigated. The application of this information to forensic investigations and laboratories could improve operative standard procedures and enhance this almost fundamental investigative tool's probative value.
Topics: Touch; DNA Fingerprinting; DNA; Specimen Handling
PubMed: 36555182
DOI: 10.3390/ijms232415541 -
Journal of Virological Methods Aug 2021The COVID-19 pandemic has resulted in an unparalleled need for viral testing capacity across the world and is a critical requirement for successful re-opening of... (Comparative Study)
Comparative Study
The COVID-19 pandemic has resulted in an unparalleled need for viral testing capacity across the world and is a critical requirement for successful re-opening of economies. The logistical barriers to near-universal testing are considerable. We have designed an injection molded polypropylene anterior nares swab, the Rhinostic, with a screw cap integrated into the swab handle that is compatible with fully automated sample accessioning and processing. The ability to collect and release both human and viral material is comparable to that of several commonly used swabs on the market. SARS-CoV-2 is stable on dry Rhinostic swabs for at least 3 days, even at 42 °C, and elution can be achieved with small volumes. To test the performance of the Rhinostic in patients, 119 samples were collected with Rhinostic and the positive and negative determinations were 100 % concordant with samples collected using Clinical Laboratory Improvement Amendments (CLIA) use approved nasal swabs at a clinical lab. The Rhinostic swab and barcoded tube set can be produced, sterilized, and packaged cost effectively and is designed to be adopted by clinical laboratories using automation to increase throughput and dramatically reduce the cost of a standard SARS-CoV-2 detection pipeline.
Topics: Automation, Laboratory; COVID-19 Nucleic Acid Testing; Humans; Nasopharynx; Polypropylenes; RNA, Viral; SARS-CoV-2; Specimen Handling
PubMed: 33984398
DOI: 10.1016/j.jviromet.2021.114153 -
JAMA Ophthalmology Jun 2023During phacoemulsification, incision leakage and the subsequent anterior chamber collapse often occur after the withdrawal of the handpiece, which cannot be prevented by... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
During phacoemulsification, incision leakage and the subsequent anterior chamber collapse often occur after the withdrawal of the handpiece, which cannot be prevented by current sealing techniques. A new technique called swab pressing is proposed here to apply pressure with a cotton swab to seal the incision immediately, but efficacy remains unknown.
OBJECTIVE
To determine if swab pressing is noninferior to stromal hydration, the current practice, in sealing incisions in phacoemulsification for age-related cataract.
DESIGN, SETTING, AND PARTICIPANTS
This noninferiority randomized controlled clinical trial was conducted between February 2022 and September 2022 at the Zhongshan Ophthalmic Center, Guangzhou, China. Patients aged 60 to 90 years with age-related cataract were enrolled.
INTERVENTIONS
Participants were randomly assigned (1:1) to receive swab pressing or stromal hydration. All surgeries were performed by a single experienced surgeon who was unmasked to the assignment.
MAIN OUTCOMES AND MEASURES
The proportion of closed clear corneal incisions evaluated using intraoperative optical coherence tomography.
RESULTS
A total of 126 eyes of 126 participants were randomized into the swab pressing group (63 [50%]) and stromal hydration group (63 [50%]). The mean (SD) age of participants was 69.2 (6.14) years and 70.1 (7.67) years in the pressing and stromal hydration groups, respectively. A total of 39 participants (61.9%) in the pressing group and 35 (55.6%) in the modified group were female. The proportion of closed incisions was 96.8% (61 of 63) in the swab pressing group and 93.7% (59 of 63) in the stromal hydration group. Noninferiority was met, as the lower 95% CI of -5.83 percentage points was greater than the prescribed noninferiority margin of -6.60 percentage points (difference, 3.17 percentage points; 95% CI, -5.83 to 12.18 percentage points). The rate of anterior chamber collapse (pressing: 0 of 63 vs stromal hydration: 35 of 63 [55.6%]; P < .001) was lower in the swab pressing group. There were no differences between the 2 groups in the proportion of closed incisions and central anterior chamber depth at postoperative hour 1 and day 1.
CONCLUSIONS AND RELEVANCE
In this study, swab pressing was noninferior to stromal hydration in sealing clear corneal incisions in phacoemulsification for age-related cataract. While this trial involved only 1 surgeon who was not masked to the interventions, the results suggest that swab pressing is feasible and further investigations would be warranted to determine if it prevents the intraoperative transient collapse of anterior chamber or affects visual acuity outcomes.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT05242653.
Topics: Humans; Female; Male; Phacoemulsification; Cataract Extraction; Anterior Chamber; Lens Implantation, Intraocular; Cataract; Cornea
PubMed: 37166786
DOI: 10.1001/jamaophthalmol.2023.1491 -
The Malaysian Journal of Pathology Apr 2020To review the present literature on upper respiratory tract sampling in COVID-19 and provide recommendations to improve healthcare practices and directions in future... (Review)
Review
INTRODUCTION
To review the present literature on upper respiratory tract sampling in COVID-19 and provide recommendations to improve healthcare practices and directions in future studies.
METHODS
Twelve relevant manuscripts were sourced from a total of 7288 search results obtained using PubMed, Medline and Google Scholar. The search keywords used were COVID-19, nasopharyngeal, oropharyngeal, swabs, SARS and CoV2. Original manuscripts were obtained and analysed by all authors. The review included manuscripts which have not undergone rigorous peer-review process in view of the magnitude of the topic discussed.
RESULTS
The viral load of SARS-CoV-2 RNA in the upper respiratory tract was significantly higher during the first week and peaked at 4-6 days after onset of symptoms, during which it can be potentially sampled. Nasopharyngeal swab has demonstrated higher viral load than oropharyngeal swab, where the difference in paired samples is best seen at 0-9 days after the onset of illness. Sensitivity of nasopharyngeal swab was higher than oropharyngeal swabs in COVID-19 patients. Patient self-collected throat washing has been shown to contain higher viral load than nasopharyngeal or oropharyngeal swab, with significantly higher sensitivity when compared with paired nasopharyngeal swab.
RECOMMENDATIONS
Routine nasopharyngeal swab of suspected COVID-19 infection should take anatomy of the nasal cavity into consideration to increase patient comfort and diagnostic yield. Routine oropharyngeal swab should be replaced by throat washing which has demonstrated better diagnostic accuracy, and it is safe towards others.
Topics: Betacoronavirus; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Coronavirus Infections; Humans; Nasopharynx; Oropharynx; Pandemics; Pneumonia, Viral; SARS-CoV-2; Sensitivity and Specificity; Specimen Handling; Viral Load
PubMed: 32342928
DOI: No ID Found -
Graefe's Archive For Clinical and... Oct 2021To investigate the presence of HPV on the ocular surface after surgical excision of HPV infected pterygia and the possible correlation of HPV with pterygium...
PURPOSE
To investigate the presence of HPV on the ocular surface after surgical excision of HPV infected pterygia and the possible correlation of HPV with pterygium postoperative recurrence.
MATERIALS AND METHODS
Both exfoliative pterygium swab samples and respective tissue specimens were received and analyzed with real-time PCR for the detection of HPV-infected pterygia. In addition, swab samples from patients that had HPV-infected pterygia with no recurrence after 1 year of follow-up, as well as swab samples from patients with healthy conjunctiva, were analyzed.
RESULTS
Forty eyes with pterygium of 40 patients and 40 eyes with normal conjunctiva were included in the study. HPV virus was detected in the tissue specimens of 11 patients (27.5%) and in the swabs of 9 patients (22.5%). The HPV subtypes detected were 33, 39, 45, 56, 59, 66, and 68. The swab test had sensitivity of 81.82% and 100% specificity. In 15 (43%) patients, a bare sclera technique was used for pterygium removal and eleven of these patients showed recurrence of the disease. Surgical excision with use of autologous conjunctival graft was performed in twenty patients and five of them had recurrence. Patients with recurrent disease were 12.41 times more likely to have an HPV-infected pterygium (p = 0.031). Furthermore, from the 11 HPV positive patients, six had no recurrence, 1 year after surgery. In five of them, a swab sample was taken from the site of the surgical excision 1 year after surgery and real-time PCR was negative for HPV presence.
CONCLUSION
Persistence of HPV infection seems to be correlated with postoperative pterygium recurrence. Further investigation with the use of the minimally invasive proposed swab technique may contribute in the understanding of pterygium pathogenesis and in the development of a more efficient treatment planning.
Topics: Conjunctiva; Follow-Up Studies; Humans; Papillomavirus Infections; Pterygium; Recurrence; Sclera; Transplantation, Autologous; Treatment Outcome
PubMed: 34155561
DOI: 10.1007/s00417-021-05267-0 -
Acute Medicine & Surgery 2022For infection control in burn patients, it is essential to understand the epidemiology of bloodstream infection (BSI) and the local microbiological situation. There are...
AIM
For infection control in burn patients, it is essential to understand the epidemiology of bloodstream infection (BSI) and the local microbiological situation. There are few studies on blood and swab culture results among burn patients in Japan. The purpose of this study was to investigate the epidemiology of BSI and swab cultures in burn patients.
METHODS
Data from 355 burn patients over 13 years from 2008 were analyzed retrospectively. Bloodstream infection was defined as the isolation of bacteria or fungi from two or more blood cultures. The characteristics of burn patients and microorganisms detected from various cultures were analyzed.
RESULTS
The mortality rate among burn patients with BSI was 37.8%, which was more than twice that among burn patients without BSI. The univariate analysis showed that inhalation injury, total burn surface area (TBSA), and mortality were associated with BSI. The multivariate logistic analysis indicated that TBSA was an independent risk factor for BSI. The most frequently isolated organism from blood and swab cultures were species and , respectively. Seventy-five percent of the microorganisms isolated from blood were detected previously in swab cultures performed within 1 week from blood cultures.
CONCLUSIONS
The prognosis of burn patients with BSI was poor, and TBSA was an independent risk factor for BSI. The predominant organisms isolated from blood and swab cultures were species and respectively. Surveillance wound swab cultures could be utilized for monitoring the local microbiological situation in burn patients.
PubMed: 35572048
DOI: 10.1002/ams2.752 -
The Journal of Applied Laboratory... Apr 2021Efficient detection of SARS-CoV-2 will continue to be an invaluable tool for pandemic control. Current instructions specify that the collection swab should be...
INTRODUCTION
Efficient detection of SARS-CoV-2 will continue to be an invaluable tool for pandemic control. Current instructions specify that the collection swab should be transported within its collection media to the laboratory. Developing a process whereby this swab is removed before transport to the lab would allow for improved automation and decreased manual manipulation of samples.
METHODS
A proof of principle approach was taken by eluting viral particles from flocked swabs into collection buffer with and without a mucus background. Paired swab-free and swab-containing samples were transported to the laboratory and evaluated for SARS-CoV-2 (n = 28) or RNaseP (n = 6). SARS-CoV-2 amplification was performed using the Hologic Panther Fusion Aptima and RT-PCR assays.
RESULTS
SARS-CoV-2 was detected in all proof of principle samples with Ct values indicative of dilution. The rare exception was for a few samples where the dilution pushed the viral load below the LOD. Paired samples were 100% concordant for SARS-CoV-2 and RNaseP detection.
CONCLUSION
Discarding the swab after inoculating the transport buffer is an appropriate preanalytical modification. Adopting this approach can save up to 1 minute per sample. For labs processing more than 500 samples per day this equates to 1 full time equivalent shift per day.
Topics: COVID-19; COVID-19 Nucleic Acid Testing; Humans; Limit of Detection; Proof of Concept Study; Ribonuclease P; SARS-CoV-2; Specimen Handling; Viral Load; Workflow
PubMed: 33119112
DOI: 10.1093/jalm/jfaa197