Comparison of Nasopharyngeal Specimens and Bronchoalveolar Lavage Specimens of Immunocompromised Adult Patients Using the Genmark DX Esensor Respiratory Viral Panel

Purpose: To determine if the multiplex real-time polymerase chain reaction respiratory viral panel (RVP) provides the same results when performed on nasal wash versus bronchoalveolar lavage from the same patient within 5 days of each other. Methods: A retrospective chart review was performed on all adult immunocompromised patients who underwent bronchoalveolar lavage (BAL) with a respiratory viral panel (RVP) obtained from the BAL fluid from February 2011 to July 2012. All patients who also had a nasal wash RVP performed within 5 days of the BAL assay were included in this study. Results: There was exact concordance between BAL and NPW specimens in 45 of 58 patients: 26 cases in which both specimens were negative and 19 cases in which the exact same viruses were present in each specimen. In 8 cases, a virus was detected in BAL fluid that was not detected in NPW fluid; in 5 cases, a virus was found in NPW fluid but not BAL. Conclusions: There was good correlation between the two assays when performed within 5 days of each other from the 2 separate specimen sources. For optimal diagnostic detection, it may be useful to repeat the assay in both locations when clinically indicated.