Nasopharyngeal swabs are the optimal specimen for detection of B. pertussis. Nasopharyngeal swabs, aspirates, and washes are better suited for recovery of respiratory syncytial virus, parainfluenza virus, and viruses causing rhinitis.

1. Observe standard precautions.

2. Tip the patient’s head back to collect a nasopharyngeal specimen.

3. Insert a flexible, calcium alginate–tipped swab carefully through the patient’s nose into the posterior nasopharynx and rotate the swab.

4. Pass two swabs simultaneously through one nostril and leave in nasopharynx for 15–30 seconds. Repeat procedure on other nostril with same two swabs. Although the calcium alginate–tipped swabs are most commonly used, aspirated nasopharyngeal specimens, obtained through a soft rubber bulb or plastic-tipped catheter, can be used.

5. Take specimens from both the nasopharyngeal area and the throat for C. diphtheriae confirmation.

6. In some cases, vacuum-assisted or bulb-collected nasopharyngeal specimens may be necessary.

7. Handle specimens as follows:

   1. Transport specimens for viral infection in appropriate transport media and refrigerate if not cultured within a few hours.

   2. Do not refrigerate samples unless for diphtheria or pertussis (whooping cough).

Normal

Negative: normal flora