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Article: Saliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study

TitleSaliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study
Authors
Issue Date2018
Citation
Clinical Microbiology and Infection, 2018 How to Cite?
AbstractObjectives: Automated point-of-care molecular assays have greatly shortened the turnaround time of respiratory virus testing. One of the major bottlenecks now lies at the step of the specimen collection especially in a busy clinical setting. Saliva is a convenient specimen type which can be provided easily from adult patients. This study assessed the diagnostic validity, specimen collection time, and cost associated with the use of saliva. Methods: This was a prospective diagnostic validity study comparing the detection rate of respiratory viruses between saliva and nasopharyngeal aspirate (NPA) among adult hospitalized patients using Xpert® Xpress Flu/RSV. The cost and time associated with the collection of saliva and nasopharyngeal specimens were also estimated. Results: Between July and October 2017, 214 patients were recruited. The overall agreement between saliva and NPA were 93.3% (196/210, κ 0.851, 95% CI 0.776-0.926). There was no significant difference in the detection rate of respiratory viruses between saliva and NPA (32.9% [69/210] vs 35.7% [75/210]; P=0.146). The overall sensitivity and specificity were 90.8% (81.9-96.2%) and 100% (97.3-100%), respectively, for saliva, and were 96.1% (88.9-99.2%) and 98.5% (94.7-99.8%), respectively, for NPA. The time and cost associated with the collection of saliva were 2.26-fold and 2.59-fold lower, respectively, than those of NPA. Conclusions: Saliva specimen has high sensitivity and specificity in the detection of respiratory viruses by an automated multiplex Clinical Laboratory Improvement Amendments (CLIA)-waived point-of-care molecular assay when compared with that of NPA. The use of saliva also reduces the time and cost associated with specimen collection.
Persistent Identifierhttp://hdl.handle.net/10722/254725

 

DC FieldValueLanguage
dc.contributor.authorTo, KKW-
dc.contributor.authorYip, CY-
dc.contributor.authorLai, CYW-
dc.contributor.authorWong, CKH-
dc.contributor.authorHo, TY-
dc.contributor.authorPang, PKP-
dc.contributor.authorNg, CK-
dc.contributor.authorLeung, KH-
dc.contributor.authorPoon, WSR-
dc.contributor.authorChan, KH-
dc.contributor.authorCheng, CCV-
dc.contributor.authorHung, FNI-
dc.contributor.authorYuen, KY-
dc.date.accessioned2018-06-21T01:05:31Z-
dc.date.available2018-06-21T01:05:31Z-
dc.date.issued2018-
dc.identifier.citationClinical Microbiology and Infection, 2018-
dc.identifier.urihttp://hdl.handle.net/10722/254725-
dc.description.abstractObjectives: Automated point-of-care molecular assays have greatly shortened the turnaround time of respiratory virus testing. One of the major bottlenecks now lies at the step of the specimen collection especially in a busy clinical setting. Saliva is a convenient specimen type which can be provided easily from adult patients. This study assessed the diagnostic validity, specimen collection time, and cost associated with the use of saliva. Methods: This was a prospective diagnostic validity study comparing the detection rate of respiratory viruses between saliva and nasopharyngeal aspirate (NPA) among adult hospitalized patients using Xpert® Xpress Flu/RSV. The cost and time associated with the collection of saliva and nasopharyngeal specimens were also estimated. Results: Between July and October 2017, 214 patients were recruited. The overall agreement between saliva and NPA were 93.3% (196/210, κ 0.851, 95% CI 0.776-0.926). There was no significant difference in the detection rate of respiratory viruses between saliva and NPA (32.9% [69/210] vs 35.7% [75/210]; P=0.146). The overall sensitivity and specificity were 90.8% (81.9-96.2%) and 100% (97.3-100%), respectively, for saliva, and were 96.1% (88.9-99.2%) and 98.5% (94.7-99.8%), respectively, for NPA. The time and cost associated with the collection of saliva were 2.26-fold and 2.59-fold lower, respectively, than those of NPA. Conclusions: Saliva specimen has high sensitivity and specificity in the detection of respiratory viruses by an automated multiplex Clinical Laboratory Improvement Amendments (CLIA)-waived point-of-care molecular assay when compared with that of NPA. The use of saliva also reduces the time and cost associated with specimen collection.-
dc.languageeng-
dc.relation.ispartofClinical Microbiology and Infection-
dc.titleSaliva as a diagnostic specimen for testing respiratory virus by a point-of-care molecular assay: a diagnostic validity study-
dc.typeArticle-
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hk-
dc.identifier.emailYip, CY: yipcyril@hku.hk-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailHo, TY: tipyinho@hku.hk-
dc.identifier.emailLeung, KH: khl17@hku.hk-
dc.identifier.emailPoon, WSR: rosana@hkucc.hku.hk-
dc.identifier.emailChan, KH: chankh2@hkucc.hku.hk-
dc.identifier.emailCheng, CCV: vcccheng@hkucc.hku.hk-
dc.identifier.emailHung, FNI: ivanhung@hkucc.hku.hk-
dc.identifier.emailYuen, KY: kyyuen@hkucc.hku.hk-
dc.identifier.authorityTo, KKW=rp01384-
dc.identifier.authorityYip, CY=rp01721-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityChan, KH=rp01921-
dc.identifier.authorityHung, FNI=rp00508-
dc.identifier.authorityYuen, KY=rp00366-
dc.identifier.doi10.1016/j.cmi.2018.06.009-
dc.identifier.hkuros285743-

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