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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.

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.

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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