Assessment of the feasibility of pool testing for SARS-CoV-2 infection screening.

Autor: Paganini I; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Sani C; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Chilleri C; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Baccini M; Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy., Antonelli A; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Bisanzi S; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Burroni E; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Cellai F; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Coppi M; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Mealli F; Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy., Pompeo G; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Viti J; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy., Rossolini GM; Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Carozzi FM; Regional Laboratory of Cancer Prevention, ISPRO, Florence, Italy.
Jazyk: angličtina
Zdroj: Infectious diseases (London, England) [Infect Dis (Lond)] 2022 Jul; Vol. 54 (7), pp. 478-487. Date of Electronic Publication: 2022 Mar 03.
DOI: 10.1080/23744235.2022.2044512
Abstrakt: Background: SARS-CoV-2 pandemic represented a huge challenge for national health systems worldwide. Pooling nasopharyngeal (NP) swabs seems to be a promising strategy, saving time and resources, but it could reduce the sensitivity of the RT-PCR and exacerbate samples management in terms of automation and tracing. In this study, taking advantage of the routine implementation of a screening plan on health workers, we evaluated the feasibility of pool testing for SARS-CoV-2 infection diagnosis in the presence of low viral load samples.
Method: Pools were prepared with an automated instrument, mixing 4, 6 or 20 NP specimens, including one, two or none positive samples. Ct values of positive samples were on average about 35 for the four genes analyzed.
Results: The overall sensitivity of 4-samples and 6-samples pools was 93.1 and 90.0%, respectively. Focussing on pools including one sample with Ct value ≥35 for all analyzed genes, sensitivity decreased to 77.8 and 75.0% for 4- and 6-samples, respectively; pools including two positive samples, resulted positive in any size as well as pools including positive samples with Ct values <35.
Conclusion: Pool testing strategy should account the balance between cost-effectiveness, dilution effect and prevalence of the infection. Our study demonstrated the good performances in terms of sensitivity and saving resources of pool testing mixing 4 or 6 samples, even including low viral load specimens, in a real screening context possibly affected by prevalence fluctuation. In conclusion, pool testing strategy represents an efficient and resources saving surveillance and tracing tool, especially in specific context like schools, even for monitoring changes in prevalence associated to vaccination campaign.
Databáze: MEDLINE
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