Nasopharyngeal Culture

Definition

A nasopharyngeal culture is used to identify pathogenic (disease causing) organisms present in the nasal cavity that may cause upper respiratory tract symptoms.

Purpose

Some organisms that cause upper respiratory infections are carried primarily in the nasopharynx, or back of the nose. The person carrying these pathogenic bacteria may have no symptoms, but can still infect others with the pathogen and resulting illness. The most serious of these organisms is Neisseriea meningitidis, which causes meningitis or blood stream infection in infants. By culturing a sample from the nasopharynx, the physician can identify this organism, and others, in the asymptomatic carrier. The procedure can also be used as a substitute for a throat culture in infants, the elderly patient, the debilitated patient, or in cases where a throat culture is difficult to obtain.

Precautions

The person taking the specimen should wear gloves, to prevent spreading infectious organisms. The patient should not be taking antibiotics, as this may influence the test results.

Description

The patient should cough before collection of the specimen. Then, as the patient tilts his or her head backwards, the caregiver will inspect the back of the throat using a penlight and tongue depressor. A swab on a flexible wire is inserted into the nostril, back to the nasal cavity and upper part of the throat. The swab is rotated quickly and then removed. Next, the swab is placed into a sterile tube with culture fluid in it for transport to the microbiology laboratory. To prevent contamination, the swab should not touch the patient's tongue or side of the nostrils.

When the sample reaches the lab, the swab will be spread onto an agar plate and the agar plate incubated for 24-48 hours, to allow organisms present to grow. These organisms will be identified and any pathogenic organisms may also be tested for susceptibility to specific antibiotics. This allows the treating physician to determine which antibiotics will be effective.

Alternative Procedures

In most cases of upper respiratory tract infections, a throat culture is more appropriate than a nasopharyngeal culture. However, the nasopharyngeal culture should be used in cases where throat cultures are difficult to obtain or to detect the carrier states of Harmophilus influenzae and meningococcal disease.

Preparation

The procedure should be described to the patient, as there is a slight discomfort associated with the procedure. Other than that, no special preparation is necessary.

Aftercare

None


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