{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:22:19Z","timestamp":1785424939342,"version":"3.56.0"},"reference-count":24,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"British Columbia Ministry of Health Innovation Pathway Program"},{"name":"BC Children's Hospital Foundation","award":["2022-03"],"award-info":[{"award-number":["2022-03"]}]},{"name":"Health Canada Safe Restart Agreement"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n \n \n This study aimed to evaluate the diagnostic yield and acceptability of parent-\/caregiver-collected oropharyngeal nasal (ON) swabs compared with healthcare worker (HCW)-collected nasopharyngeal (NP) swabs for detecting respiratory viruses and\n Mycoplasma pneumoniae<\/jats:italic>\n in children. Symptomatic children (0\u20134 years) presenting to the BC Children\u2019s Hospital Emergency Department provided HCW-collected NP and caregiver-collected ON swabs. Acceptability was assessed using a 5-point Likert scale. Samples were tested using the SARS-CoV-2\/Influenza A + B\/RSV GeneXpert assay, and a subset was tested on the BioFire respiratory panel (RP) 2.1 during the initial research phase. In a subsequent implementation phase during a high incidence of\n M. pneumoniae<\/jats:italic>\n , paired ON and NP swabs were collected and tested on the RP 2.1 in a quality improvement initiative. All\n M. pneumoniae<\/jats:italic>\n -positive samples underwent testing for cycle threshold values. We analyzed 139 pairs from the research phase and 219 from the implementation phase. Detection rates for SARS-CoV-2, influenza A\/B, and RSV were similar across swab types. Of 273 pairs tested on BioFire, ON swabs demonstrated significantly higher detection of\n M. pneumoniae<\/jats:italic>\n (sensitivity of 94%, confidence interval [CI] [86, 98] ON vs 64% [61\u201375] NP,\n P<\/jats:italic>\n = 0.0020) and comparable detection for other pathogens. Caregivers rated ON swab collection as more acceptable than NP swabs (median 4.5 [4\u20135] vs 2 [IQR 1\u20133],\n P<\/jats:italic>\n < 0.0001). ON swab performance was similar to NP swabs for the detection of respiratory viruses and showed improved diagnostic yield of\n M. pneumoniae<\/jats:italic>\n . Given their higher acceptability ratings, ON swabs should be considered as a less-invasive diagnostic option for children.\n <\/jats:p>\n \n IMPORTANCE<\/jats:title>\n \n The current clinical standard for diagnosing respiratory infections in children typically requires a nasopharyngeal (NP) swab, which may be uncomfortable for the patient and must be collected by a healthcare worker. This study presents a less-invasive option, an oropharyngeal nasal (ON) swab collected by a parent or caregiver, that has comparable detection for common respiratory viruses and improved detection for\n Mycoplasma pneumoniae<\/jats:italic>\n , a common but treatable cause of childhood pneumonia. Additionally, parents\/caregivers rated ON swabs as significantly more acceptable than NP swabs on a scale of 1 to 5. Given the increased acceptability and superior detection of treatable\n M. pneumoniae<\/jats:italic>\n , ON swabs are a patient-centered alternative to NP swabs and should be considered as a preferred diagnostic option for children.\n <\/jats:p>\n <\/jats:sec>\n <\/jats:sec>","DOI":"10.1128\/spectrum.02181-25","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T11:19:13Z","timestamp":1757675953000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Combined oropharyngeal nasal (ON) swabs for the molecular detection of respiratory pathogens including\n M. pneumoniae<\/i>\n in symptomatic children"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-1943-2259","authenticated-orcid":false,"given":"Hannah","family":"Nelson","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rmrcq20","id-type":"ROR","asserted-by":"publisher"}],"name":"Experimental Medicine Graduate Program, University of British Columbia","place":["Vancouver, Canada"]},{"id":[{"id":"https:\/\/ror.org\/01cvasn76","id-type":"ROR","asserted-by":"publisher"}],"name":"BC Children\u2019s Hospital Research Institute","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iryna","family":"Kayda","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rmrcq20","id-type":"ROR","asserted-by":"publisher"}],"name":"Experimental Medicine Graduate Program, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, BC Children\u2019s and Women\u2019s Hospital & Health Centre","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5846-3014","authenticated-orcid":true,"given":"Mai-Lei Woo","family":"Kinshella","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01cvasn76","id-type":"ROR","asserted-by":"publisher"}],"name":"BC Children\u2019s Hospital Research Institute","place":["Vancouver, Canada"]},{"id":[{"id":"https:\/\/ror.org\/03rmrcq20","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Obstetrics and Gynecology, University of British Columbia","place":["Vancouver, 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