Proper Collection of Respiratory Viral Panel PCR Samples

Collection Methods

• The most effective method for collecting a respiratory viral panel PCR sample is using a nasopharyngeal (NP) swab, which should be collected by a healthcare professional using a flocked, synthetic fiber mini-tip swab with plastic or wire shaft 1, 2
• To collect an NP swab, tilt the patient's head back 70°, insert the swab through the nares parallel to the palate, and gently rub and roll the swab to absorb secretions 1, 3
• The NP swab should be immediately placed in a sterile tube containing viral transport medium 1, 4
• The American College of Physicians recommends using flocked, synthetic fiber mini-tip swabs with plastic or wire shafts for NP swab collection 1, 3
• For oropharyngeal (OP) swab collection, insert the swab in the posterior pharynx and tonsillar areas, and rub the swab over the posterior pharynx and bilateral tonsillar pillars 1
• The OP swab should be immediately placed in a sterile tube containing transport medium 1
• The Centers for Disease Control and Prevention (CDC) recommends using synthetic fiber swabs with plastic shafts for OP swab collection 1

Important Considerations

• The Infectious Diseases Society of America recommends against using calcium alginate swabs or swabs with wooden shafts, as they may interfere with nucleic acid amplification 1
• Clinical laboratories should confirm the compatibility of collection devices during assay validation 1
• The World Health Organization (WHO) recommends immediately placing swabs in viral transport medium after collection 4, 5

Transport and Storage

• The Journal of the American Geriatrics Society recommends transporting specimens on ice within 1-2 hours after collection 4
• The Clinical Infectious Diseases journal recommends refrigerating specimens if they cannot be processed immediately 5
• The testing laboratory should provide specific transport medium requirements 1, 5

Special Situations

• The American Geriatrics Society recommends collecting nasopharyngeal wash or swab samples from several acutely ill patients at the onset of a suspected respiratory viral infection outbreak 4
• The samples should be combined with refrigerated viral transport media in a single tube and transported to an experienced laboratory for virus isolation and rapid diagnostic testing 4
• Proper instruction and supervision can improve the quality of self-collected specimens 3

Common Pitfalls to Avoid

• The Clinical Infectious Diseases journal recommends avoiding incorrect swab type, improper technique, delayed processing, and inadequate specimen collection 1, 3, 4, 6