Combined oropharyngeal nasal (ON) swabs for the molecular detection of respiratory pathogens including <i>M. pneumoniae</i> in symptomatic children
Bibliographic record
Abstract
ABSTRACT This study aimed to evaluate the diagnostic yield and acceptability of parent-/caregiver-collected oropharyngeal nasal (ON) swabs compared with healthcare worker (HCW)-collected nasopharyngeal (NP) swabs for detecting respiratory viruses and Mycoplasma pneumoniae in children. Symptomatic children (0–4 years) presenting to the BC Children’s Hospital Emergency Department provided HCW-collected NP and caregiver-collected ON swabs. Acceptability was assessed using a 5-point Likert scale. Samples were tested using the SARS-CoV-2/Influenza A + B/RSV GeneXpert assay, and a subset was tested on the BioFire respiratory panel (RP) 2.1 during the initial research phase. In a subsequent implementation phase during a high incidence of M. pneumoniae , paired ON and NP swabs were collected and tested on the RP 2.1 in a quality improvement initiative. All M. pneumoniae -positive samples underwent testing for cycle threshold values. We analyzed 139 pairs from the research phase and 219 from the implementation phase. Detection rates for SARS-CoV-2, influenza A/B, and RSV were similar across swab types. Of 273 pairs tested on BioFire, ON swabs demonstrated significantly higher detection of M. pneumoniae (sensitivity of 94%, confidence interval [CI] [86, 98] ON vs 64% [61–75] NP, P = 0.0020) and comparable detection for other pathogens. Caregivers rated ON swab collection as more acceptable than NP swabs (median 4.5 [4–5] vs 2 [IQR 1–3], P < 0.0001). ON swab performance was similar to NP swabs for the detection of respiratory viruses and showed improved diagnostic yield of M. pneumoniae . Given their higher acceptability ratings, ON swabs should be considered as a less-invasive diagnostic option for children. IMPORTANCE The current clinical standard for diagnosing respiratory infections in children typically requires a nasopharyngeal (NP) swab, which may be uncomfortable for the patient and must be collected by a healthcare worker. This study presents a less-invasive option, an oropharyngeal nasal (ON) swab collected by a parent or caregiver, that has comparable detection for common respiratory viruses and improved detection for Mycoplasma pneumoniae , a common but treatable cause of childhood pneumonia. Additionally, parents/caregivers rated ON swabs as significantly more acceptable than NP swabs on a scale of 1 to 5. Given the increased acceptability and superior detection of treatable M. pneumoniae , ON swabs are a patient-centered alternative to NP swabs and should be considered as a preferred diagnostic option for children.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".