The COVID-19 pandemic of 2020, which is caused by the SARS-CoV-2 (commonly known as the novel coronavirus), has caused a huge spike in demand for sampling swabs. While there have been swab shortages to fill the urgent need of COVID-19 testing, care still needs to be taken to qualify and source the best swab for the type of sampling that is required.

In order to meet planetary-protection requirements, culturable bacterial spore loads are measured representatively for the total microbial contamination of spacecraft. However, the National Aeronautics and Space Administration's (NASA's) cotton swab protocols for spore load determination have not changed for decades. To determine whether a more efficient alternative was available, a novel swab was evaluated for recovery of different Bacillus atrophaeus spore concentrations on stainless steel and other surfaces. Two protocols for the nylon-flocked swab (NFS) were validated and compared to the present NASA standard protocol. The results indicate that the novel swab protocols recover 3- to 4-fold more (45.4% and 49.0% recovery efficiency) B. atrophaeus spores than the NASA standard method (13.2%). Moreover, the nylon-flocked-swab protocols were superior in recovery efficiency for spores of seven different Bacillus species, including Bacillus anthracis Sterne (recovery efficiency, 20%). The recovery efficiencies for B. atrophaeus spores from different surfaces showed a variation from 5.9 to 62.0%, depending on the roughness of the surface analyzed. Direct inoculation of the swab resulted in a recovery rate of about 80%, consistent with the results of scanning electron micrographs that allowed detailed comparisons of the two swab types. The results of this investigation will significantly contribute to the cleanliness control of future life detection missions and will provide significant improvement in detection of B. anthracis contamination for law enforcement and security efforts.

This study investigates the quantitative bacterial recovery of Methicillin-resistant Staphylococcus aureus (MRSA) in nasal screenings by utilizing dry or moistened swabs within an in vivo and an in vitro experimental setting. 135 nasal MRSA carriers were each swabbed in one nostril with a dry and in the other one with a moistened rayon swab. Quantitative bacterial recovery was measured by standard viable count techniques. Furthermore, an anatomically correct artificial nose model was inoculated with a numerically defined suspension of MRSA and swabbed with dry and moistened rayon, polyurethane-foam and nylon-flocked swabs to test these different settings and swab-materials under identical laboratory conditions. In vivo, quantities of MRSA per nostril in carriers varied between 107 colony forming units, with a median of 2.15x104 CFU. However, no statistically significant differences could be detected for the recovery of MRSA quantities when swabbing nasal carriers with moist or dry rayon swabs. In vitro testing confirmed the in vivo data for swabs with rayon, polyurethane and nylon-flocked tips, since pre-moistening of swabs did not significantly affect the quantities of retrieved bacteria. Therefore, pre-moistening of swabs prior to nasal MRSA sampling provides no advantage in terms of recovering greater bacterial quantities and therefore can be omitted. In addition, this situation can be mimicked in an in vitro model, thereby providing a useful basis for future in vitro testings of new swab types or target organisms for screening approaches.

The 3D printing of nasopharyngeal swabs during the COVID-19 pandemic presents a central case of how to efficiently address a break in the global supply chain of medical equipment. Herein a comprehensive study of swab design considerations for mass production by stereolithography is presented. The retention and comfort performance of a range of novel designs of 3D-printed swabs are compared with the standard flocked-head swab used in clinical environments. Sample retention of the 3D swab is governed by the volume, porosity density, and void fraction of the head as well as by the pore geometry. 3D-printed swabs outperform conventional flock-head swabs in terms of sample retention. It is argued that mechanically functional designs of the swab head, such as corkscrew-shaped heads and negative Poisson ratio heads, maximize sample retention and improve patient comfort. In addition, available designs of swab shafts for an optimized sample collection procedure are characterized. The study is conducted in vitro, using artificial mucus, covering the full range of human mucus viscosities in a 3D-printed model of a nasal cavity. The work sets the path for the resilient supply of widespread sterile testing equipment as a rapid response to the current and future pandemics.

Not all swabs are created equal. Take, for instance, Puritan’s HydraFlock® and PurFlock Ultra® nasopharyngeal swabs, which are both included in the FDA's preferred swab-based types for viral specimen collection, including COVID-19 testing.Puritan is the only U.S. manufacturer of this swab type. Unlike an ordinary cotton swab, it’s actually a highly sophisticated diagnostic tool. In fact, it’s regulated, patented, and specialized. This also means these swabs aren’t easy to manufacture on the fly. In this article, we explore some of the characteristics that make these two styles of flock nasopharyngeal swabs ideal for viral testing. In other words, they're not your typical drugstore cotton swab. 

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