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Objectives: The objective was to estimate the probability that finding a Streptococcus pyogenes (Group A Streptococcus) in a throat swab in a patient with a sore throat reflects the aetiology. We also investigated to what extent this is influenced by age, carrier rates of S. pyogenes and climate zone. Methods: We conducted a comprehensive search of Medline and Scopus up until October 2023 for case-control studies reporting the prevalence of S. pyogenes in patients with a sore throat and healthy controls. We only included studies with separate data for children and adults. We used the positive and negative etiologic predictive values (P-EPV and N-EPV) to estimate the probability of a link between a sore throat and a finding of S. pyogenes. Results: We included 15 studies in our meta-analysis. The overall P-EPV for children and adults were 63% (49-74%) and 92% (87-95%), respectively. The P-EPV rose to 83% (64-93%) for children and 94% (90-97%) for adults when only patients with 3-4 Centor criteria were included. The overall N-EPV was 97% (96-98%) for children and 96% (95-97%) for adults. Conclusion: Detecting S. pyogenes in adult patients with an uncomplicated acute sore throat is useful to rule in S. pyogenes as the likely aetiologic agent. The P-EPV significantly increased for children when those with 3-4 Centor criteria were selected. A negative throat swab is always useful for both children and adults to rule out S. pyogenes as the cause of sore throat.

ABSTRACTObjectives The translocation of intestinal flora has been linked to the colonization of diverse and heavy lower respiratory flora in patients with septic ARDS, and is considered a critical prognostic factor for patients.Methods On the first and third days of ICU admission, BALF, throat swab, and anal swab were collected, resulting in a total of 288 samples. These samples were analyzed using 16S rRNA analysis and the traceability analysis of new generation technology.Results On the first day, among the top five microbiota species in abundance, four species were found to be identical in BALF and throat samples. Similarly, on the third day, three microbiota species were found to be identical in abundance in both BALF and throat samples. On the first day, 85.16% of microorganisms originated from the throat, 5.79% from the intestines, and 9.05% were unknown. On the third day, 83.52% of microorganisms came from the throat, 4.67% from the intestines, and 11.81% were unknown. Additionally, when regrouping the 46 patients, the results revealed a significant predominance of throat microorganisms in BALF on both the first and third day. Furthermore, as the disease progressed, the proportion of intestinal flora in BALF increased in patients with enterogenic ARDS.Conclusions In patients with septic ARDS, the main source of lung microbiota is primarily from the throat. Furthermore, the dynamic trend of the microbiota on the first and third day is essentially consistent.It is important to note that the origin of the intestinal flora does not exclude the possibility of its origin from the throat.

Background In patients without ethnicity risk factors for acute rheumatic fever (ARF), our local guidelines recommend limiting antibiotic use following a positive throat swab culture (TSC). If symptoms are severe, a 5–7 day course is recommended. Despite this, most local patients with a positive TSC for group A Streptococcus (GAS) or Streptococcus dysgalactiae subsp. equisimilis (SDSE) were being prescribed 10 days of antibiotics. In response, we added comments to positive TSC reports recommending shorter treatment durations in those without ARF risk factors. No other antimicrobial stewardship initiatives were implemented. Objectives To assess the effect of these comments on antibiotic course duration after positive TSC. Methods All community TSC results from 1 October 2021 to 31 March 2023 (1 year pre- to 6 months post-change) were matched to antibiotic dispensing data. Patients who had been empirically dispensed an antibiotic prior to the culture report were excluded. The outcome of interest was the antibiotic duration dispensed in the 5 day period after the TSC report. Results Following introduction of the comments, median course duration reduced from 10 (IQR 5–10) to 7 days (IQR 0–10; P < 0.01) and from 7 (IQR 0–10) to 0 days (IQR 0–5; P < 0.01) following GAS- and SDSE-positive TSC, respectively, in those without ARF risk factors. The percentage of people receiving 10 days of antibiotics decreased from 63.0% to 37.0% (P < 0.01) and 41.2% to 14.6% (P < 0.01) for GAS and SDSE, respectively. Conclusions The introduction of comments providing direct prescribing advice to requestors appears to have been highly effective at improving guideline-compliant prescribing following positive TSC report. [ABSTRACT FROM AUTHOR]

Background: Enterovirus infections frequently occur in children worldwide. Molecular assays are widely used to detect enterovirus. Nasopharyngeal swabs (NPS) and throat swabs (TS) are common specimen types used in clinical practice. Here, the reliability of TS for detecting enterovirus in pediatric patients was compared with that of NPS using real-time reverse transcription polymerase chain reaction (RT-rPCR). Methods: Results obtained using the Allplex Respiratory Panel 2 (Seegene, Korea) for NPS (NPS-RP) and Accu- Power EV Real-time RT-PCR (Bioneer, Korea) for TS (TS-EV), which were performed simultaneously between September 2017 to March 2020, were initially compared. Cross examination (Allplex Respiratory Panel 2 assay using TS and AccuPower EV assay with NPS) was performed for specimens collected between July 2019 to March 2020 to evaluate the performance of the enterovirus assays based on each specimen type. Results: Among the 742 case results of initial tests, 597 cases (80.5%) tested negative in both assays, and 91 cases (12.6%) tested positive in both assays. Fifty-four discrepant results were observed: 39 cases (5.3%) tested positive in TS-EV and negative in NPS-RP, and 15 cases (2.0%) tested positive in NPS-RP and negative in TS-EV. The overall percent agreement was 92.7%. In the 99 cases cross examined, overall percent agreements were 98.0%, 94.9%, 92.9%, and 89.9% for TS-EV vs. TS-RP, NPS-RP vs. NPS-EV, TS-EV vs. NPS-EV, and NPS-RP vs. TSRP, respectively. Conclusions: TS yields a high agreement rate with NPS in detecting enterovirus, regardless of single-plex or multiplex RT-rPCR assays. Thus, TS could be a good alternative specimen in pediatric patients who are reluctant to NPS sampling. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Infectious diseases are common but are not easily or readily diagnosed with current methodologies. This problem is further exacerbated by the constant presence of mutated, emerging, and novel pathogens. One of the most common sites of infection by many pathogens is the human throat. However, there is no universal diagnostic test that can distinguish these pathogens. Metatranscriptomic (MT) analysis of the throat represents an important and novel development in infectious disease detection and characterization, because it is able to identify all pathogens using a fully unbiased approach. Methods: To test the utility of an MT approach to pathogen detection, throat samples were collected from participants before, during, and after an acute sickness. Results: Clear sickness-associated shifts in pathogenic microorganisms were detected in the patients. Important insights into microbial functions and antimicrobial resistance genes were obtained. Conclusion: MT analysis of the throat represents an effective method for the unbiased identification and characterization of pathogens. Because MT data include all microorganisms in the sample, this approach should not only allow the identification of pathogens, but provide an understanding of the effects of the resident throat microbiome in the context of human health and disease.

Objective To explore whether the nucleic acid detection results of 11 pathogens in gastric juice and throat swab samples of newborns were consistent, so as to provide reference for the selection of pathogen nucleic acid detection samples.Methods A total of 120 newborns with suspected infection admitted to the pediatric intensive care unit of Jiangmen Central Hospital from February to June 2021 were selected as the research objects.Gastric juice and throat swab samples were collected within three hours after birth.Detection of 11 pathogens [chlamydia trachomatis（CT）,ureaplasma parvum（UP）,escherichia coli（EC）,ureaplasma urealyticum（UU）,neisseria gonorrhoeae（NG）,human herpes virus（HHV）,group B streptococcus（GBS）,cytomegalovirus（CMV）,Mycoplasma genitalium（MG）,enterovirus（EnV） and mycoplasma hominis（MH）] was completed by suspension bead liquid-phase chip for perinatal maternal and infant pathogen nucleic acid detection.The difference of pathogen detection rate between gastric juice and throat swab samples was compared, and the consistency of gastric juice and throat swab for the 11 pathogens was compared by Kappa test.Results The nucleic acid detection of pathogens in the 120 cases of gastric juice and throat swab samples showed that UP,EC,UU and MH were positive, and the other seven pathogens were not detected, including 14 cases of gastric juice samples and 12 cases of throat swab samples.There was no significant difference in the detection rates of UP,EC,UU and MH in the gastric juice and throat swab samples（P>0.05）,and the Kappa test showed good consistency（Kappa=0.848,0.483,1.000,1.000,P<0.05）.The overall results of gastric juice and throat swab samples were highly consistent（Kappa=0.673,P<0.001）.Conclusion The results of nucleic acid detection of 11 pathogens in gastric juice and throat swab samples of newborns are basically consistent. [ABSTRACT FROM AUTHOR]

Objective: Oral fluid (OF) is a new safe, non-invasive, convenient, and efficient biological sample that can be used for virus nucleic acid and antibody detection. Because few studies have performed surveillance of multiple respiratory pathogens, this study sought to explore the application value of OF in this field. Methods: OF and throat swabs were collected from December 2020 to December 2021 in patients with acute respiratory tract infections in Beijing. Multiplex real-time PCR was performed, and the detection performance of two samples was compared. Results: A total of 769 OF and throat swab samples were collected. The detection rates of respiratory pathogens in throat swabs and OF were 29.26% (225/769) and 20.81% (160/769), respectively. The sensitivity and specificity of the OF assay, compared with the throat swab assay, were 71.11% (160/225) and 100% (544/544), respectively. The two assays had excellent agreement (kappa = 0.78). The detection consistency varied among pathogens. For OF samples, the most common pathogen was the influenza B virus, and the highest detection rate was in the =5-year-old group. The highest positivity rate was observed in December 2021. Conclusion: OF samples have excellent potential for the epidemiological surveillance of respiratory pathogens, and may have application prospects in preventing and controlling infectious diseases. [ABSTRACT FROM AUTHOR]

This paper introduced the design and application of a fully automatic throat swab cartridge exit device for nucleic acid detection. The aim of this throat swab cartridge exit device is to improve the nucleic acid detection efficiency and reduce the risk of medical pollution diffusion. (本研究介绍一款用于核酸检测的全自动咽拭子弹出装置的设计原理与使用方法, 其在应对大规模核酸采样时, 能有效提升采样效率, 降低污染扩散风险。)

Diphtheria is an acute infectious upper respiratory tract disease caused by toxigenic strains of Corynebacterium diphtheria and can lead to significant morbidity and mortality in all the age groups. Most of the time diagnosis of diphtheria is clinical. There may be a dirty white patch covering one or both tonsils on examination for which throat swabs are collected for Kleb's-Loeffler's Bacillus (KLB) by direct microscopy and for culture and sensitivity of the organism. To find out the association between clinical diagnosis of diphtheria with smear and culture positivity. 674 cases of Clinical diphtheria were admitted from June 2017 to September 2020 at a tertiary care hospital, Sawai Mansingh Hospital, Jaipur. throat, difficulty in swallowing and swelling in the neck. Out of 674 patients of clinical diphtheria, majority 610 cases (90.5%) were found to have both KLB smear and culture negative. 13 cases (1.9%) were found to have both KLB smear and culture positive. 19 cases (2.8%) were found to have KLB smear positive and culture negative and remaining 32 cases (4.8%) were found to have KLB smear negative and culture positive. Out of 19 patients of KLB smear positive,11 cases (3.5%) were found to have complications. Out of 32 culture positive patients,24 cases (7.7%) were found to have complications. Out of 13 patients of both KLB smear and culture positive,11 cases (3.5%) were found to have complications. Our study concluded that the negative report of KLB smear and culture does not rule out diphtheria and it is evident that percentage of complication is high in patients with either KLB smear or culture or both positive with respect to both being negative. The correlation is found to be significant (p < 0.001). [ABSTRACT FROM AUTHOR]

Introduction: Streptococcus pyogenes is a medically significant member of the Streptococci. This bacterial illness affects the people frequently. It also results in toxin-related reactions, life-threatening soft tissue infections, and a range of suppurative diseases on the skin and in the respiratory system. The disease primarily affects children between 5 to 15 years old. Aim: To find the prevalence and antibiotic sensitivity pattern of Streptococcus pyogenes in upper respiratory tract infections in a tertiary health care centre. Materials and methods: A prospective study, it was carried out between August 2021 and March 2022. The research was carried out in a tertiary medical facility close to Chengalpattu, Tamil Nadu, India. The Institutional Scientific and Ethical Committees have given their prior consent. Throat swabs were collected from all age groups having upper respiratory tract infections as per standard protocols. Streptococcus pyogenes were isolated through throat swabs using conventional culture methods phenotypically and by resistance pattern were examined by using Statistical Package for the Social Sciences(SPSS) software version 24.0. Results: Out of 50 throat swabs from patients processed bacteriologically, 8 (40%) were Streptococcus pyogenes which shows the prevalence was relatively low in a period of the global covid 19 pandemic. A majority of cases occurred between 5 to 15 years of age, followed by 17(34%), 13(26%) between 16 to 30 and 31 to 45 years of age, and 5 (10%) between 46 to 60. Streptococcal infection was observed to harm men more frequently (58%) than women. Chloramphenicol and Erythromycin are 100% resistant, Cotrimoxazole is 37.5% resistant, Ofloxacin is 12.5% resistant and Bacitracin, Cefepime, Ceftriaxone, Cefazolin, Penicillin, Tetracycline, Linezolid, Vancomycin are found to be sensitive towards Streptococcus pyogenes. Conclusion: It was concluded that the prevalence of Streptococcus pyogenes is relatively low among the study population in a period of the global covid 19 pandemic. Antibiotics Chloramphenicol and Erythromycin were found to be resistant and Bacitracin, Cefepime, Ceftriaxone, Cefazolin, Penicillin, Tetracycline, Linezolid, Vancomycin were found to be sensitive for Streptococcus pyogenes. [ABSTRACT FROM AUTHOR]

Comparing the diagnostic utility of salivary specimen samples with conventional nasopharynx-oropharynx (NP-OP) specimen samples to identify COVID-19 cases by reverse transcription-polymerase chain reaction (RT-PCR). Eighty COVID-19 suspects enrolled for the paired sampling. In addition to conventional sampling, suspects were asked to follow stepwise pictorial instructions for self salivary sampling. Separate nylon swab stick was used for taking the samples from NP-OP and the floor of the oral cavity. The data were analyzed for sensitivity, specificity, concordance of COVID-19 status, and limits of agreement for cycle threshold (ct) values by either method. Forty-nine suspects (61.3%) were males, the mean age was 36.4 years. To determine the diagnostic test performance of the saliva, RT-PCR results of the NP-OP samples were used as the reference standard. Out of 80 suspects, 41 showed positivity by NP-OP swabs and 12 by salivary samples. The salivary samples showed significantly lesser positivity rate. The sensitivity and specificity of salivary samples against conventional reference standards are 24.4%, 94.9% respectively. Concordance of these two types of samples in terms of agreement kappa statistics is estimated as K = 0.252 (0.09–0.42). Median ct values of both the E and ORF1ab gene for the salivary samples were higher compared to the corresponding NP-OP sample. This study showed lesser sensitivity with salivary swab samples as compared to conventional NP-OP sampling for RT-PCR, COVID-19 detection. Hence, we are of opinion that more studies are required to establish the utility of salivary sampling in COVID-19 diagnostics. [ABSTRACT FROM AUTHOR]

• Streptococcus pyogenes is found in throat swabs from patients and healthy carriers. • Carriers of S. pyogenes ill from a virus makes the usefulness of swabs unclear. • This study clarifies post-test probabilities of a throat swab. • Finding SP has a 92%/63% probability that SP is the aetiology in adults/children. • Swabbing children with 3-4 Centor criteria alone boosts the probability to 83%. The objective was to estimate the probability that finding a Streptococcus pyogenes (Group A Streptococcus) in a throat swab in a patient with a sore throat reflects the aetiology. We also investigated to what extent this is influenced by age, carrier rates of S. pyogenes and climate zone. We conducted a comprehensive search of Medline and Scopus up until October 2023 for case-control studies reporting the prevalence of S. pyogenes in patients with a sore throat and healthy controls. We only included studies with separate data for children and adults. We used the positive and negative etiologic predictive values (P-EPV and N-EPV) to estimate the probability of a link between a sore throat and a finding of S. pyogenes. We included 15 studies in our meta-analysis. The overall P-EPV for children and adults were 63% (49-74%) and 92% (87-95%), respectively. The P-EPV rose to 83% (64-93%) for children and 94% (90-97%) for adults when only patients with 3-4 Centor criteria were included. The overall N-EPV was 97% (96-98%) for children and 96% (95-97%) for adults. Detecting S. pyogenes in adult patients with an uncomplicated acute sore throat is useful to rule in S. pyogenes as the likely aetiologic agent. The P-EPV significantly increased for children when those with 3-4 Centor criteria were selected. A negative throat swab is always useful for both children and adults to rule out S. pyogenes as the cause of sore throat. [ABSTRACT FROM AUTHOR]

• Metatranscriptomic (MT) analysis of throat swabs can identify pathogens in an unbiased manner. • Critical gene expression information can be obtained from throat swabs. • Throat swabs have the ability to proxy the lung microbiome. • Throat swabs analyzed with MT may provide insight into infectious and chronic disease. Infectious diseases are common but are not easily or readily diagnosed with current methodologies. This problem is further exacerbated by the constant presence of mutated, emerging, and novel pathogens. One of the most common sites of infection by many pathogens is the human throat. However, there is no universal diagnostic test that can distinguish these pathogens. Metatranscriptomic (MT) analysis of the throat represents an important and novel development in infectious disease detection and characterization, because it is able to identify all pathogens using a fully unbiased approach. To test the utility of an MT approach to pathogen detection, throat samples were collected from participants before, during, and after an acute sickness. Clear sickness-associated shifts in pathogenic microorganisms were detected in the patients. Important insights into microbial functions and antimicrobial resistance genes were obtained. MT analysis of the throat represents an effective method for the unbiased identification and characterization of pathogens. Because MT data include all microorganisms in the sample, this approach should not only allow the identification of pathogens, but provide an understanding of the effects of the resident throat microbiome in the context of human health and disease. [ABSTRACT FROM AUTHOR]

While IgM and IgG response to SARS-CoV-2 has been extensively studied, relatively little is known about secretory IgA (sIgA) response in respiratory mucosa. Here we report IgA response to the SARS-CoV-2 in sputum, throat swabs, and serum with nucleocapsid protein (NP) enzyme-linked immunosorbent assays (ELISA) in a cohort of 28 COVID-19 patients and 55 vaccine recipients. The assays showed sIgA in respiratory mucosa could be detected on the first day after illness onset (AIO), and the median conversion time for sIgA in sputum, throat swabs, and serum was 3, 4, and 10 days, respectively. The positive rates of sIgA first week AIO were 100% (24/28) and 85.7% (24/28) in sputum and throat swabs, respectively, and were both 100% during the mid-onset (2–3 weeks AIO). During the recovery period, sIgA positive rates in sputum and throat swabs gradually decreased from 60.7% (17/28) and 57.1% (16/28) 1 month AIO and the sIgA antibodies were all undetectable 6 months AIO. However, serum IgA positive rate was still 100% at 4 months and 53.6% (15/28) at 6 months. Throat swabs obtained from volunteers who received inactivated SARS-CoV-2 vaccines by intramuscular delivery all showed negative results in IgA ELISA. These findings will likely improve our understanding of respiratory mucosal immunity of this emerging disease and help in containing the pandemic and developing vaccines. [ABSTRACT FROM AUTHOR]

Background: In a few discharged patients with coronavirus disease 2019 (COVID-19), the nucleic acid test shows positive results again. Whether this is due to relapse of the disease, reinfection by the virus, or a false-positive result at hospital discharge is worth exploring. Case presentation: A woman with COVID-19 was discharged from the hospital after integrative treatment with traditional Chinese and Western medicine because she met the discharge standards. However, she obtained positive results on a nucleic acid test 22 days later. Conclusion: Based on this positive test result in a discharged patient with COVID-19, anal tests and coronavirus antibody tests should be combined with throat swab tests to further develop the diagnosis and discharge standards for patients with COVID-19.

We previously reported that sputum induction was more sensitive than throat swabs for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in two convalescent coronavirus disease 2019 (COVID-19) patients; however, the value and safety of induced sputum testing require further study. We conducted a prospective multi-center cross-sectional study to compare induced sputum to throat swabs for SARS-CoV-2 detection. Confirmed COVID-19 patients from six hospitals in six cities across China who received one or more negative RT-PCR result for SARS-CoV-2 were enrolled, and paired specimens (induced sputum and throat swabs; 56 cases) were assayed. In three paired samples, both the induced sputum and throat swabs were positive for SARS-CoV-2. The positive rate for induced sputum was significantly higher than for throat swabs both overall (28.6% vs 5.4%, respectively; p

While IgM and IgG response to SARS-CoV-2 has been extensively studied, relatively little is known about secretory IgA (sIgA) response in respiratory mucosa. Here we report IgA response to the SARS-CoV-2 in sputum, throat swabs, and serum with nucleocapsid protein (NP) enzyme-linked immunosorbent assays (ELISA) in a cohort of 28 COVID-19 patients and 55 vaccine recipients. The assays showed sIgA in respiratory mucosa could be detected on the first day after illness onset (AIO), and the median conversion time for sIgA in sputum, throat swabs, and serum was 3, 4, and 10 days, respectively. The positive rates of sIgA first week AIO were 100% (24/28) and 85.7% (24/28) in sputum and throat swabs, respectively, and were both 100% during the mid-onset (2–3 weeks AIO). During the recovery period, sIgA positive rates in sputum and throat swabs gradually decreased from 60.7% (17/28) and 57.1% (16/28) 1 month AIO and the sIgA antibodies were all undetectable 6 months AIO. However, serum IgA positive rate was still 100% at 4 months and 53.6% (15/28) at 6 months. Throat swabs obtained from volunteers who received inactivated SARS-CoV-2 vaccines by intramuscular delivery all showed negative results in IgA ELISA. These findings will likely improve our understanding of respiratory mucosal immunity of this emerging disease and help in containing the pandemic and developing vaccines.

Objectives: The translocation of intestinal flora has been linked to the colonization of diverse and heavy lower respiratory flora in patients with septic ARDS, and is considered a critical prognostic factor for patients., Methods: On the first and third days of ICU admission, BALF, throat swab, and anal swab were collected, resulting in a total of 288 samples. These samples were analyzed using 16S rRNA analysis and the traceability analysis of new generation technology., Results: On the first day, among the top five microbiota species in abundance, four species were found to be identical in BALF and throat samples. Similarly, on the third day, three microbiota species were found to be identical in abundance in both BALF and throat samples. On the first day, 85.16% of microorganisms originated from the throat, 5.79% from the intestines, and 9.05% were unknown. On the third day, 83.52% of microorganisms came from the throat, 4.67% from the intestines, and 11.81% were unknown. Additionally, when regrouping the 46 patients, the results revealed a significant predominance of throat microorganisms in BALF on both the first and third day. Furthermore, as the disease progressed, the proportion of intestinal flora in BALF increased in patients with enterogenic ARDS., Conclusions: In patients with septic ARDS, the main source of lung microbiota is primarily from the throat. Furthermore, the dynamic trend of the microbiota on the first and third day is essentially consistent.It is important to note that the origin of the intestinal flora does not exclude the possibility of its origin from the throat.

Objecive: This study aimed to evaluate whether Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can be detected in the tears in the eyes of Coronavirus Disease 2019 (COVID-2019) infected patients and compare the detection consistency of two simultaneously collected samples, from the tears and throat swabs. Methods: A total of 35 COVID-2019 patients were included in this cross-sectional case series study. Throat samples from all enrolled patients were collected with sampling swab, and simultaneously, tear samples were collected with sampling swab from 9 patients (No.1–9) and with Schirmer's strip from the remaining patients (No.10–35) (bilateral eyes for all patients). Sample collecting and testing were performed in three separate time points: first from patients No.1–9, second from patients No.10–29, and third from patients No. 30–35. Reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay was performed. Results: Among enrolled patients, 29 (No.1–29) had mild or moderate clinical symptoms and 6 (No.30–35) had severe symptoms. The mean time interval from the sample collection day to diagnosis confirmation day was 9.71 ± 6.50 days (ranged from 3 to 29 days). None of the patients had conjunctivitis. Nineteen out of 35 (54.3%) throat samples presented positive Rt-PCR results. Three (no.13,21,31) out of 35 (8.6%) tear samples presented positive RT-PCR results. Two (no.21, 31) of these three patients were throat swab positive and one (No. 13) was negative. The consistency analysis indicated that tears and throat samples showed poor consistency (Kappa = −0.009, P =.9).The cycle threshold value (Ct-value) of tear samples collected by sampling swab was significantly higher than that by Schirmer's strip (t = 2.288, P =.03). Conclusion: In spite of the low SARS-CoV-2 positive detection rate of tear samples from COVID-2019 patients, we cannot fully rule out the transmission by ocular surface. Whether tear testing can be used as an aid in judging of SARS-CoV-2 infection need further investigation. [ABSTRACT FROM AUTHOR]

Objective To analyze the correlation between neonatal methicillin-resistant Staphylococcus aureus (MRSA) colonization rate and MRSA nosocomial infection (hospital infection), and provide a theoretical basis for clinical interventions to prevent and reduce MRSA nosocomial infection. Methods From January 2014 to December 2018, 10 864 children who were admitted to the neonatology department of the hospital were retrospectively analyzed for the results of MRSA colonization screening and the occurrence of MRSA in throat swabs. The data collected from the old ward of the neonatology department of the hospital from 2014 to 2015 was used as the control group, and the data from the relocation to the laminar flow ward from 2016 to 2018 was used as the observation group. Results 482 strains (4.44%) of MRSA colonization were detected in 10864 newborns, of which 406 strains (84.23%) were detected in the control group and 76 strains (15.77%) were detected in the observation group. The detection rate of MRSA colonization strains in the two groups of newborns was compared, and the difference was statistically significant (P<0.05); 10,864 newborns had MRSA hospitalization in 9 cases, including 3 cases in the control group (0.07%), and 6 cases in the observation group (0.09). %). The incidence of MRSA hospitalization among the two groups of newborns was compared, and the difference was not statistically significant (P>0.05). Conclusion The transformation and upgrading of neonatal inpatient wards and the improvement of supporting hardware and software can effectively reduce the MR SA colonization rate; comprehensive intervention measures based on standard prevention can well control the transformation of neonatal MRSA from colonization to hospitalization. [ABSTRACT FROM AUTHOR]

Diagnostic testing is important for managing the 2019 novel coronavirus (SARS-CoV-2). We developed an optimized protocol for SARS-CoV-2 RNA extraction from the surface of the respiratory mucosa with nasopharyngeal swabs and compared the sensitivity of RNA extraction methods. RNA extraction was performed using three different procedures (TRIzol, QIAamp, VMT-TRIzol) from nine positive SARS-CoV-2 samples. SARS-CoV-2 was detected by real-time reverse transcriptase PCR (RT-PCR) using a detection kit for SARS-CoV-2 (Sun Yat-sen University). Compared to RT-PCR results, there were no discernible differences in detection rates when comparing the three different extraction procedures. On the basis of these results, the use of TRIzol as a transport medium and RNA extraction method for SARS-CoV-2 detection may be a helpful alternative for laboratories facing shortages of commercial testing kits.

We evaluated genetic variation in Middle East respiratory syndrome coronavirus (MERS-CoV) imported to South Korea in 2018 using specimens from a patient and isolates from infected Caco-2 cells. The MERS-CoV strain in this study was genetically similar to a strain isolated in Riyadh, Saudi Arabia, in 2017.

Directional clinical evaluation and management of coronavirus disease (Covid-19) was initially presumptive based on the Wuhan data set as reported by World Health Organization (WHO). The current recommendations emanate primarily from the Chinese experience and subsequent Centers for Disease Control and Prevention (CDC) guidelines. Here we report a case with an “atypical” patient risk profile and variant longitudinal disease progression contrasting from existing recommendations. Our case report suggests that a universal 14-day quarantine timeline may not be sufficient; that correlation is needed between viral presence as determined by RT-PCR and a patient’s humoral response tested by serologic immunoassay of IgM & IgG. Hence, a clinical decision-making algorithm that can help clinicians clear a patient from “active infection” status would require testing that is sufficiently reliable, and should include serological testing for immunity.

Acute tonsillitis is a very common medical condition. Despite different methods of detection, all tests are based on GAS sampling using a throat swab. However, obtaining the swab can elicit vomiting and is often accompanied by fear and apprehension in children. The aim of this study was to find a non-invasive method for the detection of GAS pharyngitis. A classic throat swab was obtained for culture, and a saliva sample was taken from 100 subjects recruited from Meuhedet Health Care Organization clinic. Real time PCR was performed to detect GAS dnaseB specific gene in the saliva samples. 56% of the throat cultures and 48% of the PCR samples were positive for GAS. The overall sensitivity and specificity of the saliva PCR method was 79% and 91% respectively; NPV and PPV were 77% and 92% respectively. When excluding patients who presented on the first day of fever, sensitivity and specificity increased to 90% and 100% respectively. No other anamnestic or clinical findings increased the yield of the test. Saliva-based PCR amplification of GAS DNA method is effective in detection of GAS pharyngitis. Further studies are needed to achieve detection rates to replace the traditional throat swab-based approach. [ABSTRACT FROM AUTHOR]

Background Acute tonsillitis is a very common medical condition. Despite different methods of detection, all tests are based on GAS sampling using a throat swab. However, obtaining the swab can elicit vomiting and is often accompanied by fear and apprehension in children. The aim of this study was to find a non-invasive method for the detection of GAS pharyngitis. Methods A classic throat swab was obtained for culture, and a saliva sample was taken from 100 subjects recruited from Meuhedet Health Care Organization clinic. Real time PCR was performed to detect GAS dnaseB specific gene in the saliva samples. Results 56% of the throat cultures and 48% of the PCR samples were positive for GAS. The overall sensitivity and specificity of the saliva PCR method was 79% and 91% respectively; NPV and PPV were 77% and 92% respectively. When excluding patients who presented on the first day of fever, sensitivity and specificity increased to 90% and 100% respectively. No other anamnestic or clinical findings increased the yield of the test. Conclusion Saliva-based PCR amplification of GAS DNA method is effective in detection of GAS pharyngitis. Further studies are needed to achieve detection rates to replace the traditional throat swab-based approach.

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A general survey for six months was undertaken for the prevalence of environmental bacterium Streptococcus pneumoniae among the different age groups (3-65 years) including both sexes from various hospitals of Hyderabad city. Laboratory examinations revealed S. pneumoniae as most potent environmental pathogen from the sputum and throat swabs of old aged patients and children respectively. During observations, 39 specimens were growth positive; the biochemistry of isolates revealed that they were coagulase, catalase and oxidase negative, TSI, gel hydrolysis positive and were able to ferment glucose, lactose, maltose, galactose, fructose, sucrose, starch and raffinose. The results of antimicrobial activity showed that pneumococci were resistant to the cefspan, septran, cravit, pipemetic acid, azomax, bacitracin, and penicillin and a clear zone of inhibition was observed on clithromycin, optochin, cefizox, genatamycin, minocyclin, levoflaxacin, and vancomycin. There were intermediate zone of inhibition found on claforan, nalidixic acid, amoxycillin, fosfomycin, fortum, and erythromycin on Mueller Hinton’s agar after 24 hours incubation

Human respiratory syncytial virus (HRSV) is one of the most important causes of acute respiratory infections (ARI) in young children. HRSV diagnosis is based on the detection of the virus in respiratory specimens. Nasopharyngeal swabbing is considered the preferred method of sampling, although there is limited evidence of the superiority of nasopharyngeal swabs (NPS) over the less invasive nasal (NS) and throat (TS) swabs for virus detection by real‐time reverse transcription quantitative polymerase chain reaction (RT‐qPCR). In the current study, we compared the three swabbing methods for the detection of HRSV by RT‐qPCR in children hospitalized with ARI at Mahosot Hospital, Vientiane, Laos. In 2014, NS, NPS, and TS were collected from 288 children. All three samples were tested for HRSV by RT‐qPCR; 141 patients were found positive for at least one sample. Almost perfect agreements (κ > 0.8) between the swabs, compared two by two, were observed. Detection rates for the three swabs (between 93% and 95%) were not significantly different, regardless of the clinical presentation. Our findings suggest that the uncomfortable and technically more demanding NPS method is not mandatory for HRSV detection by RT‐qPCR. [ABSTRACT FROM AUTHOR]

Background: Pharyngitis is an inflammation of throat that may be caused by viral and bacteria. Although Streptococcus pyogenes is only responsible for 5−15% of cases of pharyngitis in adults. Antibiotics are highly prescribed for this infection, thus it could lead to antibiotic resistance. The main reason for antibiotic overprescription is the difficulty to obtain a rapid and correct etiological diagnosis. This study aimed to determine the frequency of Streptococcus pyogenes from throat swab in patient with acute pharyngitis in Padjadjaran Clinic. Methods: This study was a descriptive study. Specimen was taken from the patients in Padjadjaran Clinic on September until October 2014. Thirty-five patients with acute pharyngitis that met the selection criteria were recruited for throat swab. Then, specimens obtained were performed an identification testing to determine whether there was a colonization of Streptococcus pyogenes. Results: Thirty five patients were found with acute pharyngitis consist of 14 male and 21 female, with age ranged between 16−34 years old. From the identification testing result, Streptococcus pyogenes was not found from throat swabs of patient with acute pharyngitis in Padjadjaran Clinic. Conclusions: This study found no colonization of Steptococcus pyogenes in throat swabs of acute pharyngitis patients in Padjadjaran Clinic, however Streptococcus pyogenes was not the causative fact of acute pharyngitis.

The detection of SARS-CoV-2 infection is the premise of quarantine. In many countries or areas, samples need to be shipped or inactivated before SARS-CoV-2 testing. In this study, we checked the influence of sample storage conditions on SARS-CoV-2 nucleic acid testing results, including sample inactivation time, storage temperature, and storage time. All of these conditions caused an increase in the cycle threshold values of the nucleic acid tests and led to the misclassification of at least 10.2% of positive cases as negative or suspected. The results highlight the importance of immediate testing of samples for SARS-CoV-2 nucleic acid detection. [ABSTRACT FROM AUTHOR]

Ventilator-associated pneumonia (VAP) is a common nosocomial infection in neonatal intensive care units with high morbidity and mortality. Bacterial biofilm in the endotracheal tube (ET) provides a notable and persistent source of pathogens that may cause VAP, and thus is important for VAP detection. However, during intubation microbial investigations in ET, samples are unavailable due to the infeasibility of collecting ET samples during intubation of neonates. It is therefore of great importance to find alternative sources of samples that can help identify the ET biofilm flora. In the present study, the microbial signatures of throat swabs and tracheal aspirates were compared with ET biofilm samples from VAP neonates using 16S ribosomal RNA gene polymerase chain reaction, denaturing gradient gel electrophoresis (DGGE), cloning and sequencing. Sequences were assigned to phylogenetic species using BLAST. Microbial diversity and richness among the three types of specimens were compared based on their DGGE fingerprints, and taxonomic characteristics based on the BLAST results. The microbial richness and diversity of ET biofilms were similar to tracheal aspirate yet significantly different from throat swab samples (P<0.05). Compared with ET biofilms, the overall constituent ratio of microflora was significantly different in throat swab and tracheal aspirate samples (P<0.05). However tracheal aspirate samples were useful for predicting Staphylococcus sp. in ET biofilms with a sensitivity of 85.7% and a specificity of 83.3%. The sensitivity for the combination of tracheal aspirate and throat swab samples to detect Staphylococcus sp. in ET biofilms was 100%. The detection of Pseudomonas sp. in throat swabs assisted its identification in ET biofilms (sensitivity 33.3% and specificity 100%). The results of the present study suggest that microbial investigations in throat swab and tracheal aspirate samples are beneficial for identifying the ET biofilm flora. There may therefore be clinical applications of using substituent samples to identify pathogens in ET biofilms for VAP surveillance among intubated neonates. [ABSTRACT FROM AUTHOR]

Streptolysin O is a toxin produced by Group A betahemolytic streptococcus (GABHS) or Streptococcus pyogenes, and others as group C (GCBHS) and G (GGBHS). The immunological diagnosis of infections by these microorganisms is to determine the immune response to various extracellular antigens, being the antistreptolysin O (ASO) the most widely used test. In Venezuela, this test is commonly performed, although the limits of clinical detection used are not typical of our country. For this reason, these values were determined taking into account 191 schoolchildren aged 6 to 9 years of the municipality Girardot who were asymptomatic carriers of BHS. To determine the limit values of clinical detection, an immunological agglutination indirect test (passive) was performed and, once the titles were obtained, the 95th percentile was calculated. To detect asymptomatic carriers, a bacteriological study was conducted yielding a frequency of EBH of 21.47%. The immunological characterization of groups was performed by the indirect reverse agglutination method (passive), being the GCBHS the most largely isolated group (29.27%), followed by GGBHS and GABHS (both with 21.95%), betahemolytic streptococcus group B (GBBHS) (12.19%), betahemolytic streptococcus group F (GFBHS) and unclusterable streptococci (BHSU) (both with 7.31%). The clinical detection limit value for determining ASO was set at 400 IU mL, which differs from the value recommended by the commercial manufacturer of the equipment used, so normally studied patients may have been falsely diagnosed by this test. [ABSTRACT FROM AUTHOR]