Combined oropharyngeal nasal (ON) swabs for the molecular detection of respiratory pathogens including M. pneumoniae in symptomatic children.

Combined oropharyngeal nasal (ON) swabs for the molecular detection of respiratory pathogens including M. pneumoniae in symptomatic children.

Publication date: Sep 12, 2025

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

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Concepts Keywords
Biofire microbiology
Caregivers molecular diagnostics
Iqr Mycoplasma pneumoniae
Mycoplasma nasopharyngeal swab
Pneumoniae oropharyngeal nasal swab
parent-collected swab
pediatric infectious disease
respiratory virus
self-collected swab
virology

Semantics

Type Source Name
disease MESH Emergency
pathway KEGG Influenza A
disease IDO assay
disease IDO quality
disease MESH respiratory infections
disease MESH pneumonia
disease MESH infectious disease
pathway REACTOME Infectious disease

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