Nasopharyngeal Aspiration and Nasopharyngeal Swab in the Diagnosis of RSV Children below Age 2 Presenting with Respiratory Infection Symptoms

Abstract

Introduction: Bronchiolitis is a common, acute, contagious disease in infants and young children, which is associated with lower airway obstruction. Respiratory syncytial virus (RSV) is the main cause of viral lower respiratory tract infections in infants and children worldwide. RSV infections constitute 45-83% of all viral infections. One of the easiest and quickest meth- ods to detect RSV is immunochromatography. Determination of the RSV antigen is frequently used in the samples taken from epithelial cells of the nose, nasopharynx or oropharynx where the virus is placed. In this study, although the aspiration of nasopharynx for the removal of the epithelium sample in RSV antigen determination is the gold standard, it was thought that nasopharyngeal swab could be used instead of nasopharyngeal aspiration to take an epithelial sample. By comparing the test results of the samples taken from both methods, we aimed to evaluate the usability of the nasopharyngeal swab as an alternative to aspiration. Methods: In this study, 298 infants aged between 1-24 months who were admitted to the hospital presented with acute bronchiolitis, bronchopneumonia and upper respiratory tract infection were included. Both nasopharyngeal aspiration and swab samples were taken from each patient. Immunochromatographic methods were used in the first 15-30 minutes in the emergency laboratory. Statistical analysis of the results was performed using SPSS for Windows 10.0 statistical package program. Fisher's exact test, chi-square test and Mc Nemar tests were used in the comparisons. If the obtained p-value was less than 0.05, the result is significant; if the p-value was greater than 0.05, the result is considered meaningless. Results: The frequency of RSV was 54% (161 cases). The maximum number of RSV detected was in the first six months of age. The test results were evaluated according to the time of onset of symptoms and 2-8 days were more RSV positive cases. Na- sopharyngeal aspiration, which is the gold standard in the diagnosis of RSV, had a higher sensitivity and also lower false neg- ativity than the nasopharyngeal swab. While 45.6% of RSV cases were determined by nasopharyngeal aspiration method, 39.6% of them were detected by nasopharyngeal swabs, and the difference between them was significant (p