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PCR detection of respiratory pathogens in asymptomatic and symptomatic adults.

Journal article
Authors Nicklas Sundell
Lars-Magnus Andersson
Robin Brittain-Long
Pär-Daniel Sundvall
Åsa Alsiö
Magnus Lindh
Lars Gustavsson
Johan Westin
Published in Journal of clinical microbiology
Volume 57
Issue 1
ISSN 1098-660X
Publication year 2019
Published at Institute of Medicine, Department of Public Health and Community Medicine
Institute of Biomedicine, Department of Infectious Medicine
Language en
Subject categories Family Medicine, Infectious Medicine


The frequency of viral respiratory pathogens in asymptomatic subjects is poorly defined. The aim of this study was to explore the prevalence of respiratory pathogens in the upper airways of asymptomatic adults, as compared with a reference population of symptomatic patients sampled in the same centres during the same period. Nasopharyngeal (NP) swab samples were prospectively collected from adults with and without ongoing symptoms of respiratory tract infection (RTI) during 12 consecutive months, in primary care centres as well as hospital emergency departments, and analysed for respiratory pathogens by a PCR panel detecting 16 viruses and four bacteria. Altogether, 444 asymptomatic and 75 symptomatic subjects completed sampling as well as follow-up (FU) at day 7. In the asymptomatic subjects the detection rate of viruses was low (4.3%) and the most common virus detected was rhinovirus (3.2%). Streptococcus pneumoniae was found in 5.6% of the asymptomatic subjects and Haemophilus influenzae in 1.4%. The only factor independently associated with low viral detection rate in asymptomatic subjects was age ≥65 (p=0.04). An increased detection rate of bacteria was seen in asymptomatic subjects who were currently smoking (p<0.01) and who had any chronical condition (p<0.01). We conclude that detection of respiratory viruses in asymptomatic adults is uncommon, suggesting that a positive PCR result from a symptomatic patient likely is relevant for ongoing respiratory symptoms. Age influences the likelihood of virus detection among asymptomatic adults and smoking as well as co-morbidity may increase the prevalence of bacterial pathogens in the upper airways.

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