Equivalence of self- and staff-collected nasal swabs for the detection of viral respiratory pathogens

PLoS One. 2012;7(11):e48508. doi: 10.1371/journal.pone.0048508. Epub 2012 Nov 14.


Background: The need for the timely collection of diagnostic biosamples during symptomatic episodes represents a major obstacle to large-scale studies on acute respiratory infection (ARI) epidemiology. This may be circumvented by having the participants collect their own nasal swabs. We compared self- and staff-collected swabs in terms of swabbing quality and detection of viral respiratory pathogens.

Methodology/principal findings: We conducted a prospective study among employees of our institution during the ARI season 2010/2011 (December-March). Weekly emails were sent to the participants (n = 84), reminding them to come to the study center in case of new symptoms. The participants self-collected an anterior nasal swab from one nostril, and trained study personnel collected one from the other nostril. The participants self-collected another two swabs (one from each nostril) on a subsequent day. Human β-actin DNA concentration was determined in the swabs as a quality control. Viral respiratory pathogens were detected by multiplex RT-PCR (Seeplex RV15 kit, Seegene, Eschborn, Germany). Of 84 participants, 56 (67%) reported at least one ARI episode, 18 participants two, and one participant three. Self-swabbing was highly accepted by the participants. The amount of β-actin DNA per swab was higher in the self- than in the staff-collected swabs (p = 0.008). β-actin concentration was lower in the self-swabs collected on day 1 than in those collected on a subsequent day (p<0.0001). A respiratory viral pathogen was detected in 31% (23/75) of staff- and in 35% (26/75) of self-collected swabs (p = 0.36). With both approaches, the most frequently identified pathogens were human rhinoviruses A/B/C (12/75 swabs, 16%) and human coronavirus OC43 (4/75 swabs, 5%). There was almost perfect agreement between self- and staff-collected swabs in terms of pathogen detection (agreement = 93%, kappa = 0.85, p<0.0001).

Conclusions/significance: Nasal self-swabbing for identification of viral ARI pathogens proved to be equivalent to staff-swabbing in this population in terms of acceptance and pathogen detection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coronavirus / isolation & purification*
  • Female
  • Health Personnel*
  • Humans
  • Male
  • Nose / virology
  • Prospective Studies
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / virology
  • Rhinovirus / isolation & purification*
  • Specimen Handling*

Grants and funding

This work was supported with intramural funds from the Helmholtz Association (Program Infection and Immunity). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.