Higher detection rates of Mycoplasma pneumoniae in children with acute respiratory tract infections using oropharyngeal swabs compared to nasopharyngeal swabs.

BACKGROUND

Head-to-head comparisons of nasopharyngeal swabs (NPS) and oropharyngeal swabs (OPS) for microbiological analysis in pediatric patients with acute respiratory tract infections (ARTI) remain limited. This study aimed to evaluate the concordance of NPS and OPS in identifying various etiologies among children with ARTI.

METHODS

Paired NPS and OPS samples were collected from 326 children with ARTI and analyzed for 15 respiratory pathogens using suspension microarray.

RESULTS

NPS demonstrated a higher overall microbiological yield than OPS (79 % vs. 73 %, P <0.05). The five most frequently detected pathogens were respiratory syncytial virus, Haemophilus influenzae, Mycoplasma pneumoniae (MP), Moraxella catarrhalis (MC), and rhinovirus (RV). NPS exhibited significantly higher sensitivity for MC, RV, and parainfluenza viruses compared to OPS (P <0.01). Strikingly, MP detection rates were substantially higher in OPS than in NPS (84 % vs. 29 %, P <0.001).

CONCLUSION

While NPS generally yields better results for most pathogens, OPS is superior for MP detection. Combined sampling of NPS and OPS may reduce missed ARTI diagnoses in clinical practice.