Agreement of respiratory viruses' detection between nasopharyngeal swab and bronchoalveolar lavage in adults admitted for pneumonia: a retrospective study.
Bronchoalveolar lavage
Multiplex PCR
Nasopharyngeal swab
Syndromic testing
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
received:
04
05
2022
revised:
11
12
2022
accepted:
15
12
2022
medline:
19
6
2023
pubmed:
29
1
2023
entrez:
28
1
2023
Statut:
ppublish
Résumé
The COVID-19 pandemic has highlighted the high diagnostic accuracy of the nasopharyngeal swab (including in intensive care unit (ICU) patients). This study aimed to compare nasopharyngeal swab and bronchoalveolar lavage (BAL) results for non-SARS-CoV-2 viruses in patients with suspected pneumonia. A retrospective analysis was performed in one French academic hospital on consecutive adults from 2012 to 2018 and tested nasopharyngeal swab and BAL within 24 hours by using multiplex PCR. The agreement in pathogen detection between nasopharyngeal swab and BAL was evaluated. Patients were primarily men (n = 178/276, 64.5%), with a median age of 60 years (IQR: 51-68 years). Of the 276 patients, 169 (61%) were admitted to the ICU for acute respiratory distress. We detected at least one respiratory virus in 34.4% of the nasopharyngeal swabs (n = 95/276) and 29.0% of BAL (n = 80/276). Two or more viruses were detected in 2.5% of the nasopharyngeal swabs (n = 7/276) and 2.2% of BAL (n = 6/276). Rhinovirus/enteroviruses were the most frequently detected viral group in 10.2% (n = 29/285) of the nasopharyngeal swabs and 9.5% (n = 27/285) of BAL, followed by influenza A, detected in 5.6% (n = 16/285) of the nasopharyngeal swabs and 4.9% (n = 14/285) of BAL. Overall agreement was 83.7% (n = 231/276 (95% CI [78.7%, 87.7%])) (i.e. same pathogen or pathogen combination was identified in the nasopharyngeal swab and BAL for 231 patients). Rhinovirus/enterovirus (n = 29/231) and respiratory syncytial virus (n = 13/231) had the lowest agreement of 62.1% (n = 18/29 (95% CI [42.4%-78.7%])) and 61.5% (n = 8/13 (95% CI [32.3%-84.9%])), respectively). There was a good agreement between nasopharyngeal swabs and BAL in detecting respiratory viruses among adult patients with suspected pneumonia. However, these data still encourage BAL in the case of a negative nasopharyngeal swab.
Identifiants
pubmed: 36708772
pii: S1198-743X(23)00042-3
doi: 10.1016/j.cmi.2022.12.024
pmc: PMC9873593
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
942.e1-942.e6Informations de copyright
Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
Intern Emerg Med. 2021 Oct;16(7):1857-1864
pubmed: 33770367
J Clin Virol. 2013 Dec;58(4):683-8
pubmed: 24125830
Clin Infect Dis. 2017 Nov 13;65(11):1806-1812
pubmed: 29020164
Am J Respir Crit Care Med. 2021 Jan 1;203(1):127-129
pubmed: 33125256
J Clin Microbiol. 2012 Oct;50(10):3216-21
pubmed: 22814461
PLoS One. 2020 Mar 12;15(3):e0230183
pubmed: 32163484
J Clin Microbiol. 2012 Jul;50(7):2282-8
pubmed: 22518855
J Clin Microbiol. 2015 Dec;53(12):3784-7
pubmed: 26378282
J Clin Lab Anal. 2018 Feb;32(2):
pubmed: 28397965
J Otolaryngol Head Neck Surg. 2021 Jan 28;50(1):5
pubmed: 33509292
Clin Chem Lab Med. 2020 Jun 22;58(9):1579-1586
pubmed: 32573469
BMC Infect Dis. 2012 Jul 24;12:163
pubmed: 22828244
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Nov 15;23(11):1127-1131
pubmed: 34753544
Clin Infect Dis. 2016 Apr 1;62(7):817-823
pubmed: 26747825
J Clin Microbiol. 2020 Jun 24;58(7):
pubmed: 32350043
Chest. 2021 Apr;159(4):1387-1390
pubmed: 33069724
J Clin Microbiol. 2018 May 25;56(6):
pubmed: 29593057
Can Respir J. 2018 Apr 5;2018:2685723
pubmed: 29849830