Keep specimen at 4C
Respiratory specimen of choice is a NASOPHARYNGEAL ASPIRATE. Collect the aspirate in a leukens trap and immediately transport to Clinical Virology Laboratory. Refer to the Nursing Procedure Manual, Section VII, Respiratory Care, 7:14:a for complete instructions on the collection of a nasopharyngeal aspirate using a leukens trap. Nasal washings, tracheal aspirates, and bronchoalveolar lavage specimens may be submitted. Collection of COMBINED THROAT AND NASOPHARYNGEAL SWABS is recommended for patients in which aspirates or washings cannot be readily obtained. For collection of nasopharyngeal swab specimen:1. Insert swab into one nostril.2. Press swab tip on the mucosal surface of the mid-inferior portion of the inferior turbinate, and rub the swab tip several times across the mucosal surface to loosen and collect cellular material.3. Withdraw the swab; place swab into tube of Viral Transport Medium.For collection of oropharyngeal swab specimen:1. Ask patient to open mouth widely and phonate an 'ah'.2. Gently depress the tongue with a tongue blade.3. Guide a swab over the tongue into the posterior oropharynx.4. Using a gentle back-and-forth sweeping motion, swab the area behind the uvula and between the tonsillar pillars.5. Withdraw the swab; place swab into the same tube of Viral Transport Medium that contains the nasoparyngeal swab. Immediately transport to the Clinical Virology Laboratory. If an extended delay in transport of specimens is anticipated, rapidly freeze the specimens to at least -60°C and transport to the laboratory on dry ice. Please consult the laboratory if necessary.
Swab specimens not received in viral transport medium or received in bacteriological transport medium are discouraged. DO NOT USE CALCIUM ALGINATE OR WOODEN SHAFT SWABS FOR COLLECTION OF SPECIMENS; ONLY USE DACRON OR RAYON TIPPED SWABS ON PLASTIC OR METAL SHAFTS.
Amplification and detection of adenovirus DNA using real-time TaqMan PCR and nucleic acid primer/probe pairs specific for conserved regions of the adenovirus genome. Detects all 51 known serotypes of adenoviruses; does not differentiate by type. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
If positive, results are reported as adenovirus DNA detected.
Negative or no adenovirus DNA detected
Clinical Utility: RESPIRATORY: Adenoviruses are important causes of acute upper and lower respiratory tract illnesses in immunocompetent infants and children. Manifestations include the common cold, pharyngitis, tonsillitis, conjunctivitis, pharyngoconjuntival fever, croup, a pertussis-like syndrome, bronchiolitis, and pneumonia. OCULAR: Adenoviruses are commonly associated with acute follicular conjunctivitis and pharyngoconjunctival fever, and less frequently with epidemic keratoconjunctivitis (occurs mainly in adults) in immunocompetent individuals. GASTROINTESTINAL: The fastidious adenovirus types 40 and 41 can cause viral gastroenteritis. These adenovirus types are widespread and cause endemic diarrhea and outbreaks of diarrhea; infections appear to occur year-round. DISSEMINATED INFECTIONS: Adenoviruses can cause life-threatening disseminated infections in young infants and immunocompromised hosts such as bone marrow, liver, kidney, and lung transplant recipients and patients with primary immunodeficiency disorders, AIDS or malignancies. Clinical manifestations of adenovirus disease in immunocompromised patients include pneumonia, hepatitis, nephritis, colitis, encephalitis, hemorrhagic cystitis, and myocarditis. Detection of adenovirus DNA in blood plasma is useful for identifying immunocompromised patients at risk for invasive disease. Depending on the particular patient and specific disease, other specimens may be submitted as well. These include bone marrow, tissue (e.g., liver, lung, kidney, colon, endomyocardial biopsy), CSF, urine, respiratory, conjunctival, and stool.