Test ID RESPM Respiratory Pathogen Panel, PCR, Nasopharyngeal
Advisory Information
This assay is not predicted to detect severe acute respiratory syndrome coronavirus (SARS-CoV, Middle East respiratory syndrome-coronavirus (MERS-CoV), or SARS-CoV-2, which causes coronavirus disease-2019 (COVID-19).
This test is not intended for otherwise healthy, immunocompetent patients who are likely to have a mild, self-limited respiratory infection. If testing is desired, these patients should be tested using the more targeted diagnostic assays based on their exposure history and clinical presentation.
-FLUNP / Influenza Virus Type A and Type B, and Respiratory Syncytial Virus (RSV), Molecular Detection, PCR, Nasopharyngeal Swab
-BPRP / Bordetella pertussis and Bordetella parapertussis, Molecular Detection, PCR, Varies
-MPRP / Mycoplasma pneumoniae, Molecular Detection, PCR, Varies
It is not recommended that the following tests be concomitantly ordered when this test is ordered:
-FLUNP / Influenza Virus Type A and Type B, and Respiratory Syncytial Virus (RSV), Molecular Detection, PCR, Nasopharyngeal Swab
-LADV / Adenovirus, Molecular Detection, PCR, Varies
-LENT / Enterovirus, Molecular Detection, PCR, Varies
-BPRP / Bordetella pertussis and Bordetella parapertussis, Molecular Detection, PCR, Varies
-MPRP / Mycoplasma pneumoniae, Molecular Detection, PCR, Varies
This test is appropriate for nasopharyngeal swabs only. For bronchoalveolar lavage or bronchial washings specimens, order RESLR / Respiratory Pathogen Panel, PCR, Varies.
Shipping Instructions
Specimens that cannot be shipped refrigerated to Mayo Clinic Laboratories within 3 days (72 hours) should be frozen prior to shipment. Specimens received older than 72 hours (refrigerated) or older than 30 days (frozen) will be canceled.
Specimen Required
Specimen Type: Nasopharyngeal Swab
Collection Container/Tube: Swab, See Additional Information for acceptable swabs.
Submission Container/Tube: Viral transport media, See Additional Information for acceptable media.
Specimen Volume: Entire collection/1 swab
Collection Instructions: Nasopharyngeal swab specimens should be collected according to standard technique and immediately placed into viral transport media and submitted for testing.
Additional Information:
If any nasopharyngeal swab or viral transport media not listed below is utilized, testing may be canceled.
Acceptable nasopharyngeal swabs: Copan Rayon Swabs, Copan Nylon Flocked Swabs, Copan Polyester Swabs, Puritan Calcium Alginate Swabs
Acceptable viral transport media: Remel M4, Remel M4-RT, Remel M5, Remel M6, BD Universal Viral Transport vial, PrimeStore Molecular Transport Medium (MTM), Sigma-Virocult Viral Collection and Transport System (Swab and transport medium), Copan ESwab Sample Collection and Delivery System (Swab and Liquid Amies Medium)
Forms
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Useful For
Rapid detection of respiratory infections caused by the following:
-Adenovirus
-Coronavirus (serotypes HKU1, NL63, 229E, OC43)
-Human metapneumovirus
-Human rhinovirus/enterovirus
-Influenza A (H1, H1-2009, H3)
-Influenza B
-Parainfluenza virus (serotypes 1-4)
-Respiratory syncytial virus (RSV)
-Bordetella pertussis
-Bordetella parapertussis
-Chlamydophila pneumoniae
-Mycoplasmoides pneumoniae
This test is not recommended as a test of cure.
Method Name
Multiplex Polymerase Chain Reaction (PCR)
Reporting Name
Respiratory Pathogen Panel, PCR, NPSpecimen Type
VariesSpecimen Minimum Volume
Nasopharyngeal swab in minimum volume of 1 mL of viral transport media (eg, M4-RT or M5)
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Refrigerated (preferred) | 72 hours | |
Frozen | 30 days | ||
Ambient | 4 hours |
Clinical Information
Respiratory infections are common and generally cause self-limited illnesses in healthy, immunocompetent hosts. Viruses account for a significant percentage of respiratory diseases, but bacteria may be associated with respiratory infections. Although respiratory illnesses are frequently mild, viruses may cause significant morbidity and mortality in immunocompromised hosts (eg, transplant recipients, patients with underlying malignancies).
Influenza viruses (type A and type B) and respiratory syncytial virus (RSV) are 2 common causes of viral respiratory illness, with peak incidence in the winter and spring months in the Northern hemisphere. Both viruses can cause a clinically indistinguishable syndrome, characterized by fever, cough, headache, and general malaise. RSV is a leading cause of respiratory illness in young children. Early diagnosis of influenza and RSV is important so that 1) necessary infection control precautions can be taken if the patient is hospitalized, and 2) antiviral therapy can be considered if the patient is hospitalized or considered at high-risk for severe disease.(1) Human metapneumovirus is also a cause of respiratory illness in both children and adults.
Human rhinovirus and coronavirus (serotypes HKU1, NL63, 229E, OC43) are the causative agents of the common cold, with symptoms including runny nose, sore throat, and malaise. Infections with rhinovirus and coronaviruses are extremely common, due to the large number of serotypes of these viruses. Most infections are mild and self-limiting; however, immunocompromised hosts may suffer more severe illnesses, including lower respiratory tract disease.
Parainfluenza viruses and adenovirus are also common causes of viral infection, especially in young children. Parainfluenza viruses are most common during the spring, summer, and fall months, with symptoms including fever, runny nose, and cough. However, parainfluenza viruses may also cause more severe lower respiratory disease, such as croup or pneumonia. Adenoviruses may infect a range of organ systems, with sequelae ranging from cold-like symptoms (sore throat), to pneumonia, conjunctivitis (pink eye), or diarrhea. Similarly to the viruses described above, parainfluenza viruses and adenoviruses generally cause mild, self-limited infections but may cause severe disease in immunosuppressed patients.
Respiratory infections may also be caused by bacterial pathogens, including Bordetella pertussis, Bordetella parapertussis, Chlamydophila pneumoniae, and Mycoplasmoides pneumoniae (previously Mycoplasma pneumoniae). Bordetella pertussis is the causative agent of pertussis, or whooping cough, a disease characterized by prolonged cough that may be associated with an inspiratory whoop and post-tussive vomiting. Bordetella parapertussis causes a similar, but generally less severe illness. Mycoplasmoides pneumoniae is a cause of upper respiratory infection, pharyngitis, tracheobronchitis, and pneumonia. Chlamydophila pneumoniae is a rare cause of pneumonia.
Reference Values
Negative (for all targets)
Interpretation
Results are intended to aid in the diagnosis of illness and are meant to be used in conjunction with other clinical and epidemiological findings.
A negative result should not rule-out infection in patients with a high pretest probability for a respiratory infection. The assay does not test for all potential infectious agents of respiratory disease. Specimens collected too early or too late in the clinical course may not yield the organism causing disease. Negative results should be considered in the context of a patient's clinical course and treatment history, if applicable.
For immunocompromised patients who have a negative FilmArray respiratory panel test from a nasopharyngeal sample, but a high suspicion for infection, there may be additional value in testing a bronchoalveolar lavage specimen (RESLR / Respiratory Pathogen Panel, PCR, Varies).
Positive results do not distinguish between a viable or replicating organism and the presence of a nonviable organism or nucleic acid, nor do they exclude the potential for coinfection by organisms not included in the panel. Nucleic acid may persist in some patients for days to weeks, even following appropriate therapy. Detection of 1 or more organisms included in this test suggests that the virus or bacteria is present in the clinical sample; however, the test does not distinguish between organisms that are causing disease and those that are present but not associated with a clinical illness. Coinfections (eg, detection of multiple viruses or bacteria or viruses and bacteria) may be observed with this test. In these situations, the clinical history and presentation should be reviewed thoroughly to determine the clinical significance of multiple pathogens in the same specimen.
Clinical Reference
1. Lee N, Lui GC, Wong KT, et al: High morbidity and mortality in adults hospitalized for respiratory syncytial virus infections. Clin Infect Dis. 2013:57(8):1069-1077
2. Miliander C, Espy M, Binnicker MJ: Evaluation of the BioFire FilmArray for the detection of respiratory viruses in clinical samples. Clinical Virology Symposium Annual Meeting. Daytona, Florida; April 2013
3. Ramanan P, Bryson AL, Binnicker MJ, Pritt BS, Patel R: Syndromic panel-based testing in clinical microbiology. Clin Microbiol Rev. 2017 Nov 15;31(1):e00024-17. doi: 10.1128/CMR.00024-17
Day(s) and Time(s) Performed
Monday through Sunday
Analytic Time
1 dayTest Classification
This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
0100U
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
RESPM | Respiratory Pathogen Panel, PCR, NP | 82159-5 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
SS021 | Specimen Source | 31208-2 |
36086 | Adenovirus | 82160-3 |
36087 | Coronavirus 229E | 82163-7 |
36088 | Coronavirus HKU1 | 82161-1 |
36089 | Coronavirus NL63 | 82162-9 |
36090 | Coronavirus OC43 | 82164-5 |
36091 | Human Rhinovirus/ Enterovirus | 82175-1 |
36093 | Human Metapneumovirus | 82165-2 |
36094 | Influenza A | 82166-0 |
36095 | Influenza B | 82170-2 |
36096 | Parainfluenza Virus 1 | 82171-0 |
36097 | Parainfluenza Virus 2 | 82172-8 |
36098 | Parainfluenza Virus 3 | 82173-6 |
36099 | Parainfluenza Virus 4 | 82174-4 |
36100 | Respiratory Syncytial Virus | 82176-9 |
36101 | Bordetella pertussis | 82179-3 |
607058 | Bordetella parapertussis | 87621-9 |
36102 | Chlamydophila pneumoniae | 82178-5 |
36103 | Mycoplasmoides (Mycoplasma) pneumoniae | 82177-7 |
36312 | Interpretation | 59464-8 |