Effectiveness of Patient-Collected Swabs for Influenza Testing

• Published in: Mayo Clinic proceedings Vol. 87; no. 6; pp. 548 - 554
• Main Authors: Dhiman, Neelam, PhD, Miller, Rita M., RN, Finley, Janet L., RN, Sztajnkrycer, Matthew D., MD, Nestler, David M., MD, MS, Boggust, Andy J., MD, Jenkins, Sarah M., MS, Smith, Thomas F., PhD, Wilson, John W., MD, Cockerill, Franklin R., MD, Pritt, Bobbi S., MD
• Format: Journal Article
• Language: English
• Published: Rochester, MN Elsevier Inc 01.06.2012; Mayo Foundation; Elsevier, Inc; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Body Fluids - virology; Comparative analysis; Female; General aspects; Human viral diseases; Humans; Infectious diseases; Influenza viruses; Internal Medicine; Male; Medical sciences; Medical tests; Methods; Middle Aged; Nasal Mucosa - virology; Original; Patient Satisfaction; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Real-Time Polymerase Chain Reaction; Specimen Handling - methods; Viral diseases; Viral diseases of the respiratory system and ent viral diseases; Young Adult; Minnesota; health care worker; real-time reverse transcription–polymerase chain reaction; ILI; emergency department; influenzalike-illness; Cp; HCW; crossing point; ED; rRT-PCR; Infection; Human; Medicine; Efficiency; Viral disease; Influenza; Samplings; Patient; Medical screening
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2012.02.011

Abstract Objective To compare the effectiveness of self-collected and health care worker (HCW)–collected nasal swabs for detection of influenza viruses and determine the patients' preference for type of collection. Patients and Methods We enrolled adult patients presenting with influenzalike illness to the Emergency Department at Mayo Clinic, Rochester, Minnesota, from January 28, 2011, through April 30, 2011. Patients self-collected a midturbinate nasal flocked swab from their right nostril following written instructions. A second swab was then collected by an HCW from the left nostril. Swabs were tested for influenza A and B viruses by real-time reverse transcription–polymerase chain reaction, and percent concordance between collection methods was determined. Results Of the 72 paired specimens analyzed, 25 were positive for influenza A or B RNA by at least one of the collection methods (34.7% positivity rate). When the 14 patients who had prior health care training were excluded, the qualitative agreement between collection methods was 94.8% (55 of 58). Two of the 58 specimens (3.4%) from patients without health care training were positive only by HCW collection, and 1 of 58 (1.7%) was positive only by patient self-collection. A total of 53.4% of patients (31 of 58) preferred the self-collection method over the HCW collection, and 25.9% (15 of 58) had no preference. Conclusion Self-collected midturbinate nasal swabs provide a reliable alternative to HCW collection for influenza A and B virus real-time reverse transcription–polymerase chain reaction.