Respiratory medicine · 2025
Molecular diagnosis of respiratory viral infections in cystic fibrosis, sputum versus nasopharyngeal samples.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Legros Romain, Stefic Karl, Ramel Sophie, Pronier Charlotte, Dina Julia, Cardot-Martin Emilie, Schnuriger Aurélie, Gaudy-Graffin Catherine, Le Berre Rozenn, Revillet Hélène, Héry-Arnaud Geneviève, Vallet Sophie, Mucovir study group
Аннотация
BACKGROUND: Respiratory viral infections in people with Cystic Fibrosis (pwCF) significantly impact disease progression, and their molecular diagnosis should be part of the recommendations. Sputum, the routinely used specimen for bacterial culture, could also be used for viral molecular diagnosis, avoiding an additional invasive nasopharyngeal swab or aspirate. Our primary objective was to evaluate whether invasive nasopharyngeal samples (NP) and non-invasive sputum specimens are equally accurate for the diagnosis of viral infections in pwCF.
METHODS: We conducted a prospective and multicentre study in 11 French CF centres. A total of 111 pwCF (children or adults, all able to expectorate) presenting with acute respiratory symptoms were included. Each provided paired NP and sputum, which were analysed using multiplex PCR panels detecting a broad spectrum of respiratory viruses, in addition to standard clinical evaluation and microbiological findings.
RESULTS: Among 111 paired samples, 69 NP and 64 sputa tested positive for ≥1 virus, with 94 pairs yielding concordant results (58 both positive, 36 both negative). Overall NP-sputum agreement was substantial (Cohen's κ = 0.68 [0.60; 0.75]), and even higher for the most prevalent viruses (enterovirus/rhinovirus, κ = 0.74 [0.65; 0.80] and influenza viruses, κ = 0.95 [0.87; 0.97]). The detection of a virus in one or both specimens was independent of the presence of a bacterial pathogen in sputum culture.
CONCLUSION: These results confirmed the suitability of sputum sampling as an alternative to NP sampling for the diagnosis of viral respiratory infection in pwCF, ensuring patients' comfort.
METHODS: We conducted a prospective and multicentre study in 11 French CF centres. A total of 111 pwCF (children or adults, all able to expectorate) presenting with acute respiratory symptoms were included. Each provided paired NP and sputum, which were analysed using multiplex PCR panels detecting a broad spectrum of respiratory viruses, in addition to standard clinical evaluation and microbiological findings.
RESULTS: Among 111 paired samples, 69 NP and 64 sputa tested positive for ≥1 virus, with 94 pairs yielding concordant results (58 both positive, 36 both negative). Overall NP-sputum agreement was substantial (Cohen's κ = 0.68 [0.60; 0.75]), and even higher for the most prevalent viruses (enterovirus/rhinovirus, κ = 0.74 [0.65; 0.80] and influenza viruses, κ = 0.95 [0.87; 0.97]). The detection of a virus in one or both specimens was independent of the presence of a bacterial pathogen in sputum culture.
CONCLUSION: These results confirmed the suitability of sputum sampling as an alternative to NP sampling for the diagnosis of viral respiratory infection in pwCF, ensuring patients' comfort.