Ekstraksiyon İçermeyen PCR Bazlı Sars-Cov-2 Testi İçin Tükürük Örneği ve Nazofaringeal Sürüntü Örnek Alma Yöntemlerinin Karşılaştırılması
Öz
Günümüzde COVID-19'un kesin tanısı için en önemli yöntem, nazofaringeal sürüntü (NS) örneklerinde şiddetli akut solunum sendromu koronavirüs 2 (SARS-CoV-2) RNA'sının RT-PCR ile tanımlanmasıdır. Nazofaringeal sürüntü örneğinin alınması bazen olumsuz etkileri olan rahatsız edici bir işlem olup, örneklemeyi yapan sağlık personeli için de enfeksiyon riski oluşturmaktadır. SARS-CoV-2 tanısında tükürük örneğini kullanmak NS'ye göre daha az invaziv alternatif bir yöntemdir. Altın standart NS ile tükürük protokollerinin uyumunu değerlendiren çalışmalar sınırlıdır. Bu çalışmanın amacı, PCR bazlı SARS-CoV-2 tanısında, sağlık çalışanı tarafından alınan NS örneği ile tükürük örneği ve kişinin kendinden NS alma yöntemini karşılaştırmaktır. 2178 hastadan alınan tükürük ve NS örnekleme çeşitleri SARS-CoV-2 varlığı açısından RT-PCR ile analiz edilmiştir. Örneklerinden en az birinde SARS-CoV-2 tespit edilen 684 hastanın, sağlık çalışanı tarafından alınan NS örneğinin 606'sı (%88,59), kişinin kendinden aldığı NS örneğinin 402'si (%58,77) ve tükürük örneğinin 456'sı (%66,66) pozitif bulunmuştur. Kişinin kendinden aldığı NS örneği ve tükürük örneklerinin kullanılabilmesi istatistik olarak anlamlı bulunmuştur. NS örneklerine alternatif yöntemin olması hastaları invaziv ve ağrılı bir işlemden kurtaracak ve örnek alan sağlık personelinin enfeksiyon riskini azaltacaktır. SARS-CoV-2 tanısında tükürük örneklerinin ya da kişinin kendinden aldığı NS örneğinin test için kullanımı, hastanelerin iş yükünü azaltabilir, test sonuçlarının süresini kısaltabilir, asemptomatik popülasyonları test etmek için daha fazla kapasite sağlayarak enfekte hastaların hızlı bir şekilde izolasyonunu sağlayabilecektir.
Anahtar Kelimeler
Kaynakça
- Afzal A. 2020. Molecular diagnostic technologies for COVID-19: limitations and challenges. J Adv Res, 26: 149-159.
- Azzi L, Carcano G, Gianfagna F, Grossi P, Gasperina DD, Genoni A. 2020. Saliva is a reliable tool to detect SARS-CoV-2. J Infect, 81: e45-e50.
- Bennett S, Davidson RS, Gunson RN. 2017. Comparison of gargle samples and throat swab samples for the detection of respiratory pathogens. J Virol Meth, 248: 83-86.
- Braz-Silva PH, Mamana AC, Romano CM. 2020. Performance of at-home selfcollected saliva and nasal-oropharyngeal swabs in the surveillance of COVID-19. J Oral Microbiol, 13(1): 1858002.
- Fernandes LL, Pacheco VB, Borges L, Athwal HK, de Paula EF, Bezinelli L. 2020. Saliva in the diagnosis of COVID-19: a review and new research directions. J Dent Res, 99: 1435-1443.
- Goldfarb DM, Tilley P, Al-Rawahi GN, Srigley JA, Ford G, Pedersen H. 2021. Self-collected saline gargle samples as an alternative to health care worker-collected nasopharyngeal swabs for COVID-19 diagnosis in outpatients. J Clin Microbiol, 59(4): e02427-e2520.
- Gopaul R, Davis J, Gangai L, Goetz L. 2020. Practical diagnostic accuracy of nasopharyngeal swab testing for novel coronavirus disease 2019 (COVID-19). West J Emerg Med, 21(6): 1. DOI: 10.5811/westjem.2020.8.48420:1-4.
- Gupta K, Bellino PM, Charness ME. 2021. Adverse effects of nasopharyngeal swabs: Three-dimensional printed versus commercial swabs. Infect Control Hosp Epidemiol, 42(5): 641-642.
- Huff HV, Singh A. 2020. Asymptomatic transmission during the Coronavirus disease 2019 pandemic and implications for public health strategies. Clin Infect Dis, 71(10): 2752-2756.
- Kim YG, Yun SG, Kim MY. 2016. Comparison between Saliva and Nasopharyngeal Swab specimens for detection of respiratory viruses by multiplex reverse transcription-PCR. J Clin Microbiol, 55(1): 226-233.
- Li L, Chen QY, Li YY. 2013. Comparison among nasopharyngeal swab, nasal wash, and oropharyngeal swab for respiratory virüs detection in adults with acute pharyngitis. BMC Infect Dis, 13: 281.
- Lieberman D, Lieberman D, Shimoni A. 2009. Identification of respiratory viruses in adults: nasopharyngeal versus oropharyngeal sampling. J Clin Microbiol, 47(11): 3439-3443.
- Liu R, Han H, Liu F. 2020. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta, 505: 172- 175.
- Mahmoud SA, Ganesan S, Ibrahim E. 2021. Evaluation of RNA extraction free method for detection of SARS-COV-2 in salivary samples for mass screening for COVID-19. Biomed Res Int, 2021: 5568350.
- Mughal Z, Luff E, Okonkwo O, Hall CEJ. 2020. Test, test, test-a complication of testing for coronavirus disease 2019 with nasal swabs. J Laryngol Otol, 134: 646-649.
- Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, Agha M, Agha R. 2020. The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg, 78: 185-193.
- Önder H. 2018. Nonparametric statistical methods used in biological experiments. BSJ Eng Sci, 1(1): 1-6.
- Tan SH, Allicock O, Armstrong-Hough M. 2021. Saliva as a gold-standard sample for SARS-CoV-2 detection. Lancet Respir Med, 9(6): 562-564.
- Tang YW, Schmitz JE, Persing DH, Stratton CW. 2020. Laboratory diagnosis of COVID-19: current issues and challenges. J Clin Microbiol, 58: 1-22.
- Vaz SN, de Santana DS, Netto EM. 2020. Saliva is a reliable, non-invasive specimen for SARS-CoV-2 detection. Brazilian J Infect Dis, 24(5): 422-427.
- Xu K, Chen Y, Yuan J, Yi P, Ding C, Wu W. 2020. Factors associated with prolonged viral RNA shedding in patients with Coronavirus disease 2019. Clin Infect Dis, 71: 799-806.
Comparison of Saliva Sample and Nasopharyngeal Swab Sampling Methods for Non-Extraction PCR-Based SARS-CoV-2 Testing
Öz
Currently, the most important method for the definitive diagnosis of COVID-19 is the identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA in nasopharyngeal swab (NS) samples by RT-PCR. Taking a nasopharyngeal swab sample is an uncomfortable procedure that sometimes has adverse effects, and poses a risk of infection for the health personnel performing the sampling. Using a saliva sample in the diagnosis of SARS-CoV-2 is a less invasive alternative method compared to NS. Studies evaluating the compatibility of the gold standard NS and salivary protocols are limited in literature. The aim of this study is to compare the NS sample taken by the healthcare worker with the saliva sample and the method of self NS taking in the PCR-based diagnosis of SARS-CoV-2 RNA. NS and Saliva variant samples of 2178 patients were tested against SARS-CoV-2 by RT-PCR. 684 SARS-CoV-2 patients were identified in at least one of their samples,606 (88.59%) of the NS sample taken by the healthcare worker, 402 (58.77%) of the NS sample taken by the individual and 456 of the saliva sample (66.66%) were found to be positive. It was found statistically significant that the NS sample and saliva samples taken from the person could be used. Being able to collect NS samples with different procedures those substitute one another will extricate patients from adisturbing and hurting methods and leşsen infection risk for healthcare personnel collecting samples. Using self-acquired NS samples or saliva samples to test SARS-CoV- presence 2 will dial down the hospital burden, decrease time for test results, accommodate more capacity to diagnose asymptomatic populations, and enable swift isolation of infected patients.
Anahtar Kelimeler
Kaynakça
- Afzal A. 2020. Molecular diagnostic technologies for COVID-19: limitations and challenges. J Adv Res, 26: 149-159.
- Azzi L, Carcano G, Gianfagna F, Grossi P, Gasperina DD, Genoni A. 2020. Saliva is a reliable tool to detect SARS-CoV-2. J Infect, 81: e45-e50.
- Bennett S, Davidson RS, Gunson RN. 2017. Comparison of gargle samples and throat swab samples for the detection of respiratory pathogens. J Virol Meth, 248: 83-86.
- Braz-Silva PH, Mamana AC, Romano CM. 2020. Performance of at-home selfcollected saliva and nasal-oropharyngeal swabs in the surveillance of COVID-19. J Oral Microbiol, 13(1): 1858002.
- Fernandes LL, Pacheco VB, Borges L, Athwal HK, de Paula EF, Bezinelli L. 2020. Saliva in the diagnosis of COVID-19: a review and new research directions. J Dent Res, 99: 1435-1443.
- Goldfarb DM, Tilley P, Al-Rawahi GN, Srigley JA, Ford G, Pedersen H. 2021. Self-collected saline gargle samples as an alternative to health care worker-collected nasopharyngeal swabs for COVID-19 diagnosis in outpatients. J Clin Microbiol, 59(4): e02427-e2520.
- Gopaul R, Davis J, Gangai L, Goetz L. 2020. Practical diagnostic accuracy of nasopharyngeal swab testing for novel coronavirus disease 2019 (COVID-19). West J Emerg Med, 21(6): 1. DOI: 10.5811/westjem.2020.8.48420:1-4.
- Gupta K, Bellino PM, Charness ME. 2021. Adverse effects of nasopharyngeal swabs: Three-dimensional printed versus commercial swabs. Infect Control Hosp Epidemiol, 42(5): 641-642.
- Huff HV, Singh A. 2020. Asymptomatic transmission during the Coronavirus disease 2019 pandemic and implications for public health strategies. Clin Infect Dis, 71(10): 2752-2756.
- Kim YG, Yun SG, Kim MY. 2016. Comparison between Saliva and Nasopharyngeal Swab specimens for detection of respiratory viruses by multiplex reverse transcription-PCR. J Clin Microbiol, 55(1): 226-233.
- Li L, Chen QY, Li YY. 2013. Comparison among nasopharyngeal swab, nasal wash, and oropharyngeal swab for respiratory virüs detection in adults with acute pharyngitis. BMC Infect Dis, 13: 281.
- Lieberman D, Lieberman D, Shimoni A. 2009. Identification of respiratory viruses in adults: nasopharyngeal versus oropharyngeal sampling. J Clin Microbiol, 47(11): 3439-3443.
- Liu R, Han H, Liu F. 2020. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta, 505: 172- 175.
- Mahmoud SA, Ganesan S, Ibrahim E. 2021. Evaluation of RNA extraction free method for detection of SARS-COV-2 in salivary samples for mass screening for COVID-19. Biomed Res Int, 2021: 5568350.
- Mughal Z, Luff E, Okonkwo O, Hall CEJ. 2020. Test, test, test-a complication of testing for coronavirus disease 2019 with nasal swabs. J Laryngol Otol, 134: 646-649.
- Nicola M, Alsafi Z, Sohrabi C, Kerwan A, Al-Jabir A, Iosifidis C, Agha M, Agha R. 2020. The socio-economic implications of the coronavirus pandemic (COVID-19): a review. Int J Surg, 78: 185-193.
- Önder H. 2018. Nonparametric statistical methods used in biological experiments. BSJ Eng Sci, 1(1): 1-6.
- Tan SH, Allicock O, Armstrong-Hough M. 2021. Saliva as a gold-standard sample for SARS-CoV-2 detection. Lancet Respir Med, 9(6): 562-564.
- Tang YW, Schmitz JE, Persing DH, Stratton CW. 2020. Laboratory diagnosis of COVID-19: current issues and challenges. J Clin Microbiol, 58: 1-22.
- Vaz SN, de Santana DS, Netto EM. 2020. Saliva is a reliable, non-invasive specimen for SARS-CoV-2 detection. Brazilian J Infect Dis, 24(5): 422-427.
- Xu K, Chen Y, Yuan J, Yi P, Ding C, Wu W. 2020. Factors associated with prolonged viral RNA shedding in patients with Coronavirus disease 2019. Clin Infect Dis, 71: 799-806.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 7 Ekim 2023 |
| Yayımlanma Tarihi | 15 Ekim 2023 |
| Gönderilme Tarihi | 30 Ağustos 2023 |
| Kabul Tarihi | 2 Ekim 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 6 Sayı: 4 |
