Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study
IntroductionSore throat is a common reason for overuse of antibiotics. The value of inflammatory or biomarkers in throat swab or saliva samples in predicting benefit from antibiotics is unknown.MethodsWe used the ‘person-based approach’ to develop an online tool to support self-swabbing and recruite...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1016181/full |
| _version_ | 1811229360163651584 |
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| author | Mark Lown Elizabeth A. Miles Helena L. Fisk Kirsten A. Smith Ingrid Muller Emma Maund Kirsty Rogers Taeko Becque Gail Hayward Michael Moore Paul Little Margaret Glogowska Alastair D. Hay Beth Stuart Efi Mantzourani Chris Butler Jennifer Bostock Firoza Davies Ian Dickerson Natalie Thompson Nick Francis |
| author_facet | Mark Lown Elizabeth A. Miles Helena L. Fisk Kirsten A. Smith Ingrid Muller Emma Maund Kirsty Rogers Taeko Becque Gail Hayward Michael Moore Paul Little Margaret Glogowska Alastair D. Hay Beth Stuart Efi Mantzourani Chris Butler Jennifer Bostock Firoza Davies Ian Dickerson Natalie Thompson Nick Francis |
| author_sort | Mark Lown |
| collection | DOAJ |
| description | IntroductionSore throat is a common reason for overuse of antibiotics. The value of inflammatory or biomarkers in throat swab or saliva samples in predicting benefit from antibiotics is unknown.MethodsWe used the ‘person-based approach’ to develop an online tool to support self-swabbing and recruited adults and children with sore throats through participating general practices and social media. Participants took bacterial and viral swabs and a saliva sponge swab and passive drool sample. Bacterial swabs were cultured for streptococcus (Group A, B, C, F and G). The viral swab and saliva samples were tested using a routine respiratory panel PCR and Covid-19 PCR testing. We used remaining viral swab and saliva sample volume for biomarker analysis using a panel of 13 biomarkers.ResultsWe recruited 11 asymptomatic participants and 45 symptomatic participants. From 45 symptomatic participants, bacterial throat swab, viral throat swab, saliva sponge and saliva drool samples were returned by 41/45 (91.1%), 43/45 (95.6%), 43/45 (95.6%) and 43/45 (95.6%) participants respectively. Three saliva sponge and 6 saliva drool samples were of insufficient quantity. Two adult participants had positive bacterial swabs. Six participants had a virus detected from at least one sample (swab or saliva). All of the biomarkers assessed were detectable from all samples where there was sufficient volume for testing. For most biomarkers we found higher concentrations in the saliva samples. Due to low numbers, we were not able to compare biomarker concentrations in those who did and did not have a bacterial pathogen detected. We found no evidence of a difference between biomarker concentrations between the symptomatic and asymptomatic participants but the distributions were wide.ConclusionsWe have demonstrated that it is feasible for patients with sore throat to self-swab and provide saliva samples for pathogen and biomarker analysis. Typical bacterial and viral pathogens were detected but at low prevalence rates. Further work is needed to determine if measuring biomarkers using oropharyngeal samples can help to differentiate between viral and bacterial pathogens in patients classified as medium or high risk using clinical scores, in order to better guide antibiotic prescribing and reduce inappropriate prescriptions. |
| first_indexed | 2024-04-12T10:13:43Z |
| format | Article |
| id | doaj.art-8eebb3464e78400da6eb9207db2bc0cd |
| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-12T10:13:43Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-8eebb3464e78400da6eb9207db2bc0cd2022-12-22T03:37:15ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-10-011310.3389/fimmu.2022.10161811016181Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility studyMark Lown0Elizabeth A. Miles1Helena L. Fisk2Kirsten A. Smith3Ingrid Muller4Emma Maund5Kirsty Rogers6Taeko Becque7Gail Hayward8Michael Moore9Paul Little10Margaret Glogowska11Alastair D. Hay12Beth Stuart13Efi Mantzourani14Chris Butler15Jennifer Bostock16Firoza Davies17Ian Dickerson18Natalie Thompson19Nick Francis20Primary Care Research Centre, University of Southampton, Southampton, United KingdomSchool of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United KingdomSchool of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomNuffield Department of Primary Care, University of Oxford, Oxford, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomNuffield Department of Primary Care, University of Oxford, Oxford, United KingdomCentre for Academic Primary Care, National Institute for Health Research (NIHR) School for Primary Care Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomSchool of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, United KingdomNuffield Department of Primary Care, University of Oxford, Oxford, United KingdomSouthampton Primary Care Research Centre, Patient and Public Involvement Representative, Southampton, United KingdomSouthampton Primary Care Research Centre, Patient and Public Involvement Representative, Southampton, United KingdomSouthampton Primary Care Research Centre, Patient and Public Involvement Representative, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomPrimary Care Research Centre, University of Southampton, Southampton, United KingdomIntroductionSore throat is a common reason for overuse of antibiotics. The value of inflammatory or biomarkers in throat swab or saliva samples in predicting benefit from antibiotics is unknown.MethodsWe used the ‘person-based approach’ to develop an online tool to support self-swabbing and recruited adults and children with sore throats through participating general practices and social media. Participants took bacterial and viral swabs and a saliva sponge swab and passive drool sample. Bacterial swabs were cultured for streptococcus (Group A, B, C, F and G). The viral swab and saliva samples were tested using a routine respiratory panel PCR and Covid-19 PCR testing. We used remaining viral swab and saliva sample volume for biomarker analysis using a panel of 13 biomarkers.ResultsWe recruited 11 asymptomatic participants and 45 symptomatic participants. From 45 symptomatic participants, bacterial throat swab, viral throat swab, saliva sponge and saliva drool samples were returned by 41/45 (91.1%), 43/45 (95.6%), 43/45 (95.6%) and 43/45 (95.6%) participants respectively. Three saliva sponge and 6 saliva drool samples were of insufficient quantity. Two adult participants had positive bacterial swabs. Six participants had a virus detected from at least one sample (swab or saliva). All of the biomarkers assessed were detectable from all samples where there was sufficient volume for testing. For most biomarkers we found higher concentrations in the saliva samples. Due to low numbers, we were not able to compare biomarker concentrations in those who did and did not have a bacterial pathogen detected. We found no evidence of a difference between biomarker concentrations between the symptomatic and asymptomatic participants but the distributions were wide.ConclusionsWe have demonstrated that it is feasible for patients with sore throat to self-swab and provide saliva samples for pathogen and biomarker analysis. Typical bacterial and viral pathogens were detected but at low prevalence rates. Further work is needed to determine if measuring biomarkers using oropharyngeal samples can help to differentiate between viral and bacterial pathogens in patients classified as medium or high risk using clinical scores, in order to better guide antibiotic prescribing and reduce inappropriate prescriptions.https://www.frontiersin.org/articles/10.3389/fimmu.2022.1016181/fullsore throat diagnosisinflammatory markersswabssalivainfection |
| spellingShingle | Mark Lown Elizabeth A. Miles Helena L. Fisk Kirsten A. Smith Ingrid Muller Emma Maund Kirsty Rogers Taeko Becque Gail Hayward Michael Moore Paul Little Margaret Glogowska Alastair D. Hay Beth Stuart Efi Mantzourani Chris Butler Jennifer Bostock Firoza Davies Ian Dickerson Natalie Thompson Nick Francis Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study Frontiers in Immunology sore throat diagnosis inflammatory markers swabs saliva infection |
| title | Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study |
| title_full | Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study |
| title_fullStr | Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study |
| title_full_unstemmed | Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study |
| title_short | Self-sampling to identify pathogens and inflammatory markers in patients with acute sore throat: Feasibility study |
| title_sort | self sampling to identify pathogens and inflammatory markers in patients with acute sore throat feasibility study |
| topic | sore throat diagnosis inflammatory markers swabs saliva infection |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.1016181/full |
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