Related Experiment Video
Updated: Jul 29, 2025
Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples
Published on: January 21, 2018
Comparison between Nasopharyngeal and Saliva Samples for the Detection of Respiratory Viruses in Children with Acute
Danilo Buonsenso1,2, Piero Valentini1, Francesco Mariani1
1Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A Gemelli IRCCS, 00168 Rome, Italy.
Insights
Saliva swabs show low sensitivity for detecting common respiratory viruses in children with lower respiratory tract infections. This method is less effective in younger children and requires improved saliva collection strategies.
Area of Science:
- Pediatric infectious diseases
- Respiratory virus diagnostics
- Molecular diagnostics
Background:
- Salivary swabs (SS) are increasingly used for SARS-CoV-2 detection in children.
- The utility of SS for other common respiratory viruses in pediatric populations remains under-investigated.
Purpose of the Study:
- To evaluate the diagnostic performance of salivary swabs (SS) for common respiratory viruses in children.
- To compare SS performance against nasopharyngeal swabs (NPS) as the gold standard.
Main Methods:
- Prospective study of children under 18 years with respiratory symptoms.
- Simultaneous collection of nasopharyngeal and salivary swabs.
- Calculation of sensitivity, specificity, PPV, and NPV for SS compared to NPS.
Main Results:
- Overall SS sensitivity was 49.4%, with virus-specific sensitivity ranging from 0% to 71.43%.
- Specificity was high (96%-100%), but PPV varied widely (0%-100%).
- Lower sensitivity was observed in infants (<12 months) and in patients with less saliva collected.
Conclusions:
- Salivary swabs demonstrate limited sensitivity for detecting common respiratory viruses in children with LRTI.
- Diagnostic accuracy is reduced in younger children and those with insufficient saliva samples.
- Novel approaches for saliva collection are necessary to enhance diagnostic yield in pediatric respiratory infections.
Purpose:
During the COVID-19 pandemic, the use of salivary swabs (SS) to detect the SARS-CoV-2 virus has been implemented and widely studied in adults and children. However, the role of SS in detecting other common respiratory viruses in children is poorly investigated.
Methods:
Children younger than 18 years of age admitted with respiratory signs and symptoms underwent both nasopharyngeal and SS procedures. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SS were calculated, considering the nasopharyngeal swab result as the gold standard.
Results:
A total of 83 patients (44 females, 53%) underwent both nasopharyngeal and SS procedures. Overall, the sensitivity of SS was 49.4%. Sensitivity according to different respiratory viruses ranged from 0% to 71.43%, while the specificity ranged from 96% to 100%. Negative predictive value ranged from 68.06% to 98.8%, while positive predictive value ranged from 0 to 100%. SS sensitivity in patients younger than 12 months of age was 39.47%, while in patients older than or equal to 12 months of age it was 57.78%. Patients with negative SS had a significantly lower median age (8.5 months (15.25) vs. 23 months (34), p = 0.001) and a significantly lower quantity of median saliva collected for salivary analysis (0 μL (213) vs. 300 μL (100), p < 0.001).
Conclusions:
SS has a relatively low sensitivity in detecting common respiratory viruses in children with LRTI, with a lower probability in younger children (and in particular those younger than 6 months of age) or those from whom we have collected lesser amounts of saliva. New strategies to improve saliva collection are needed for testing on a larger study population.
More Related Videos
Related Concept Videos
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:20Sputum Studies II: Culture and Sensitivity
Sputum culture and sensitivity is a medical procedure used to diagnose bacterial infections in the respiratory tract and select the most appropriate antibiotics for treatment. This process involves analyzing sputum samples of thick and opaque secretions produced in the lungs and airways. These samples are collected from patients and then sent to the laboratory for analysis.
The test can identify various pathogens responsible for respiratory infections, including Streptococcus,...