COPAN’S TRANSPORT MEDIUM (UTM®-RT) AND FLOCKED SWAB FOR RSV/FLU COLLECTION

ABSTRACT

Background: The “gold standard” specimen for viral respiratory testing is a nasopharyngeal (NP) aspirate or wash collected by respiratory therapists or physicians. A new collection device, a “flocked” swab (Copan Diagnostics Inc., Corona, California), was recently introduced that allows for collection and release of additional patient material. This new design would allow the collection of the specimen by nursing staff.

Design/Methods: Specimens were collected as follows: Gently pass the swab through the nose and into the posterior nasopharynx. Rotate the swab on the nasopharyngeal membrane 5-6 times and allow it to remain in place for 10-15 seconds. Remove the swab and repeat the procedure in the other nares. Remove the swab and snap it off inside the UTM-RT tube.

Results: The incidence rate of RSV and Flu during peak months did not decrease signifi cantly from previous years, indicating that the quality of specimen has remained consistent. The incidence of indeterminate or unreadable results did not increase over previous years. An internal survey indicated that the new fl ocked swabs were comfortable, showed a high degree of patient tolerability, and were well accepted by nursing staff collecting NP samples.

Conclusions: The use of the flocked swab/UTM combination appears to have had no negative impact on the Binax test systems. The use of the flocked swab combined with a 1-mL fi ll UTM offered flexibility in testing by allowing both the rapid antigen tests and viral culture with minimal specimen dilution. The specimens were easily collected by nursing staff with high patient satisfaction.

BACKGROUND

The “gold standard” specimen for viral respiratory testing is a nasopharyngeal (NP) aspirate or wash. A respiratory therapist or specially trained nurse is often required to collect these specimens. Frequently the NP wash would be diluted with several ml of saline yielding false negative results due to dilution. This was determined by repeat swabbing of the NP of clinically infected patients and putting the swab into a 1 ml of saline and repeating the test. The alternative specimen is a standard rayon NP swab. Unfortunately specimens collected with these swabs often yield poor results due to an inadequate amount material collected. A new collection device, a “flocked” swab (Copan Diagnostics Inc., Corona, California), was recently introduced. The design of the swab allows for collection and release of additional patient material. This new design would allow the collection of the specimen by all the hospital staff. The use of the flocked swab combined with a 1-mL fi ll UTM® would offer flexibility in testing by allowing both the rapid antigen tests and viral culture but would not have the dilution effect seen in the NP washes.

METHODS

Specimen Collection:

Specimens were collected as follows:

1) Gently pass the swab through the nose and into the
posterior nasopharynx.
2) Rotate the swab on the nasopharyngeal membrane
5-6 times and allow it to remain in place for 10-15
seconds.
3) Remove the swab and repeat the procedure in the
other nares.
4) Remove the swab and snap it off inside the 1.0-mL
Mini-UTM® tube.
5) Transport the specimen to the lab for testing at
ambient temperature.

Binax Procedure:

1) Vortex Flocked Swab and UTM®.
2) Remove Binax device from pouch just prior to
testing and lay fl at on work bench.
3) Fill pipette by fi rmly squeezing the top bulb and
placing pipette tip into sample. Release bubble while
tip is still in sample. This will pull liquid into pipette.
Make sure there are no air spaces in the lower part
of the pipette.
4) SLOWLY (drop by drop) add entire contents of
pipette (100-μL) to the MIDDLE of this pad by
squeezing the top bulb.
5) Immediately peel off brown adhesive liner
from the test device. Close and securely seal
the device.
6) Read results in window 15-minutes after
closing device.