TABLE 1.
Comparison of specimens and sampling methods for the detection of different respiratory pathogensa
| Pathogen | Sample ranking | Method | Age (yr) | Total no. of specimens/no. of patients | Reference |
|---|---|---|---|---|---|
| M. pneumoniae | Sputum > TW > NPS > OPS | PCR | 20-93 | 552/144 | 31 |
| OPS > NPS | PCR | NSp | 132/66 | 43 | |
| OPS > BAL > sputum | PCR | NSp | 325/197 | 49 | |
| Sputum > OPS | Gene-probe test | >18 | 160 | 57 | |
| Sputum > NPA | Ag-EIA | >18 | 102/51 | 56 | |
| Sputum > OPS | Culture, PCR, NASBA | NSp | 302/180 | 61, 62 | |
| NPS = OPS | PCR | NSp | 63 | 69 | |
| Sputum > NPA = OPS | PCR | 22-29 | 96/32 | 79 | |
| OPS > NPA | PCR | NSp | 102 | 82 | |
| C. pneumoniae | NPS > TS | Culture, PCR | 3-12 | 260 | 10 |
| Sputum > NPS = OPS | PCR, culture | 3-79 | 319/129 | 12 | |
| OPS > NPS | PCR | NSp | 132/66 | 43 | |
| Sputum > NPA > OPS | PCR | NSp | 105/35 | 58 | |
| NPS > OPS > sputum | PCR | 20-93 | 468/156 | 103 | |
| RSV | PFS = NPA | DFA | 0-5 | 910/455 | 1 |
| NPA > NPFS | PCR | 0-18 | 338/169 | 19 | |
| NPA > NPFS | DIF | 0-18 | 338/169 | 19 | |
| NPA = NPS | Culture, IFA | 0-16 | 250/125 | 38 | |
| NPA > NPS | DIF | 0-2 | 366/183 | 64 | |
| NPA > NPS | Culture, Ag-EIA, FAT | 0-18 | 242/121 | 67 | |
| Adenovirus | PFS = NPA | DFA | 0-5 | 910/455 | 1 |
| Parainfluenza virus 1, 2, or 3 | PFS = NPA | DFA | 0-5 | 910/455 | 1 |
| Picornaviruses | Sputum > NS > OPS | Culture | 5-15 | 66/22 | 50 |
| Influenza virus | PFS = NPA | DFA | 0-5 | 910/455 | 1 |
| NPS > NS > NPA | Quidel quickvue | 0-18 | 366/122 | 2 | |
| NPFS = NPA | PCR | 0-18 | 338/169 | 19 | |
| NPA > NPFS | DIF | 0-18 | 338/169 | 19 | |
| Sputum > NA > NPS > OPS | FLU OIA test | 0-76 | 403/184 | 24 | |
| NA > sputum > NPS > OPS | Culture | 0-76 | 403/184 | 24 | |
| NPS > NPA > OPS | PCR, Directigen Flu A+B | 61-97 | 85/47 | 44 | |
| NPS > OPS | Binax Now, Directigen Flu A+B, DIF | NSp | 521/448 | 93 | |
| All viruses | NPA>NS = OPS | PCR | 0-16 | 221/178 | 46 |
| NFS = NA >unpreserved saline | PCR | 0-1.5 | 543/181 | 105 | |
| NPA > NS | PCR, culture, DIF | ≤5 | 950/475 | 97 |
a
BAL, bronchoalveolar lavage; DIF, direct immunofluorescence; DFA, direct fluorescent antibody assay; Ag-EIA, antigen enzyme immunoassay; IFA, indirect fluorescent antibody test; FAT, fluorescent antibody test; NA, nasal aspirate; NASBA, nucleic acid sequence-based amplification; NPA, nasopharyngeal aspirate; NPFS, nasopharyngeal flocked swab; NFS, nasal flocked swab; NPS, nasopharyngeal swab; NW, nasal wash; NSp, not specified; NS, nasal swab; OPS, oropharyngeal swab; PFS, pernasal flocked swab; TW, throat wash. (Adapted from reference 111 with permission of the publisher.)