A Look Inside: Oral Sampling for Detection of Non-oral Infectious Diseases

Valinetz, Ethan; Cangelosi, Gerard A.

doi:10.1128/jcm.02360-20

Cited by 22 publications

(25 citation statements)

References 52 publications

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“…The manual qPCR method used in Table 1 performed well in past OSA studies [7,8,14] but is impractical for routine diagnostic use. Therefore, as a secondary analysis we used the semi-automated Cepheid GeneXpert MTB/RIF Ultra platform to test a subset of 18 frozen swab samples from the current study (11 S1).…”

Section: Resultsmentioning

confidence: 99%

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Complementary non-sputum diagnostic testing using oral swabs and urine LAM testing for TB in people with HIV

Shapiro

Olson

Kidoguchi

et al. 2022

Preprint

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Testing for mycobacterial lipoarabinomannan (LAM) in urine is a practical but insensitive alternative to sputum testing to diagnose tuberculosis (TB) in people with HIV (PWH). We evaluated urine LAM testing conducted in parallel with tests for Mycobacterium tuberculosis DNA in oral swabs. In a cohort of 131 South Africans (92% with HIV), combined urine LAM and oral swab testing was significantly more sensitive than either sample tested alone (57% vs. 35% and 39%, respectively), and 97% specific, compared to reference sputum testing (TB culture and Xpert Ultra). Complementary non-sputum sample testing increased sensitivity of TB diagnosis, without sacrificing specificity.

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Section: Resultsmentioning

confidence: 99%

“…In search of an alternative non-sputum sample type, we and others have shown that MTB DNA can be detected by oral swab analysis (OSA) [6][7][8][9][10][11][12][13][14]. In OSA, the dorsum of the tongue is brushed with a sterile swab, and the collected material is tested for MTB DNA.…”

Section: Introductionmentioning

confidence: 99%

Complementary non-sputum diagnostic testing using oral swabs and urine LAM testing for TB in people with HIV

Shapiro

Olson

Kidoguchi

et al. 2022

Preprint

Self Cite

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“…For instance, in clinically unstable and/or immunocompromised individuals where BAL collection may not be safe, NAATs can be carried out on oral washes to make diagnosis of P. jirovecii pneumonia. Similarly, NAATs can be used to perform large scale screening of SARS-CoV-2 in oral fluids when nasopharyngeal swabs are difficult to collect, such as in children [73]. Even if the performances of NAATs in detecting pathogens from oral samples when more invasive samples are not easily obtainable are encouraging, attention should be paid in interpretation of these results.…”

Section: Emerging Technologies In Rapid Microbiological Diagnosis For...mentioning

confidence: 99%

“…Indeed, a positive result may simply represent colonization, as it could happen in case of P. jirovecii, while a negative result at the oral level may not exclude a lower respiratory tract infection, as in case of SARS-CoV-2. Therefore, a clinical judgment is always recommended for a correct interpretation of results [73].…”

Section: Emerging Technologies In Rapid Microbiological Diagnosis For...mentioning

confidence: 99%

Rapid diagnostic tests in the management of pneumonia

Riccobono

Bussini

Giannella

et al. 2021

Expert Review of Molecular Diagnostics

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Introduction: Pneumonia is one of the main causes of mortality associated with infectious diseases worldwide. Several challenges have been identified in the management of patients with pneumonia, ranging from accurate and cost-effective microbiological investigations, prompt and adequate therapeutic management, and optimal treatment duration. Areas covered: In this review, an updated summary on the current management of pneumonia patients is provided and the epidemiological issues of infectious respiratory diseases, which in the current pandemic situation are of particular concern, are addressed. The clinical and microbiological approaches to pneumonia diagnosis are reviewed, including discussion about the new molecular assays pointing out both their strengths and limitations. Finally, the current recommendations about antibiotic treatment are examined and discussed depending on the epidemiological contexts, including those with high prevalence of multidrug-resistant bacteria. Expert opinion: We claim that rapid diagnostic tests, if well-positioned in the diagnostic workflow and reserved for the subset of patients who could most benefit from these technologies, may represent an interesting and feasible tool to optimize timing of targeted treatments especially in terms of early deescalation or discontinuation of antibiotic therapy.

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“…Tongue swabbing, also known as oral swab analysis (OSA), has emerged as a potential alternative to sputum-based molecular testing [9]. Compared to sputum collection, tongue swabbing is faster, easier, and safer.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of tongue swab testing using Xpert MTB-RIF Ultra for tuberculosis diagnosis

Andama

Whitman

Crowder

et al. 2022

Preprint

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Tongue dorsum swabs have shown promise as alternatives to sputum for detecting Mycobacterium tuberculosis (MTB) in patients with pulmonary tuberculosis (TB). Some of the most encouraging results have come from studies that used manual quantitative PCR (qPCR) to analyze swabs. Studies using the automated Cepheid Xpert MTB/RIF Ultra qPCR test (Xpert Ultra) have yielded less encouraging results with tongue swabs, possibly because Xpert Ultra is optimized for testing sputum, not tongue swab samples. Using two new sample processing methods that demonstrated good sensitivity in preliminary experiments, we assessed diagnostic accuracy and semi-quantitative signals of 183 tongue swab samples using Xpert Ultra in a clinical setting. Relative to a sputum Xpert Ultra reference standard, the sensitivity of tongue swab Xpert Ultra was 68.5% (95% CI 54.4-80.5) and specificity was 100.0% (95% CI 97.2-100.0). When compared to a microbiological reference standard (MRS) incorporating both sputum Xpert Ultra and sputum culture, sensitivity was 64.9 (95% CI 51.1-77.1) and specificity remained the same. Higher sensitivities were observed when trace Xpert results were included among positive swabs. Semi-quantitative Xpert Ultra results were generally lower with swabs than with sputum. None of the eight sputum Xpert Ultra trace or very low results were detected using tongue swabs. Tongue swabs should be considered when sputum cannot be collected for Xpert Ultra testing, or in certain mass-screening settings. Further optimization of tongue swab analysis is needed to achieve parity with sputum-based molecular testing for TB.

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A Look Inside: Oral Sampling for Detection of Non-oral Infectious Diseases

Cited by 22 publications

References 52 publications

Complementary non-sputum diagnostic testing using oral swabs and urine LAM testing for TB in people with HIV

Complementary non-sputum diagnostic testing using oral swabs and urine LAM testing for TB in people with HIV

Rapid diagnostic tests in the management of pneumonia

Accuracy of tongue swab testing using Xpert MTB-RIF Ultra for tuberculosis diagnosis

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