Tay Joshua K, Cross Gail B, Sun Louisa, Chia Alfred, Chee Jeremy, Loh Jerold, Lim Zhen Yu, Ngiam Nicholas, Khang Wen Pang, Yeap Stephanie, Goh Han Lee, Siow Chor Hiang, Loh Woei Shyang, Loh Kwok Seng, Lee Chun Kiat, Yan Benedict, Chow Vincent T K, Wang De Yun, Boey Freddy, Wong John E L, Allen David M
Department of Otolaryngology-Head and Neck Surgery, National University of Singapore, Singapore, Singapore.
Division of Infectious Diseases, Department of Medicine, National University Hospital, Singapore, Singapore.
Infect Dis Ther. 2021 Jun;10(2):1015-1022. doi: 10.1007/s40121-020-00391-6. Epub 2021 Jan 11.
The gold standard for COVID-19 diagnosis is currently a real-time reverse transcriptase polymerase chain reaction (RT-PCR) to detect SARS-CoV-2. This is most commonly performed on respiratory secretions obtained via a nasopharyngeal swab. Due to supply chain limitations and high demand worldwide because of the COVID-19 pandemic, access to commercial nasopharyngeal swabs has not been assured. 3D printing methods have been used to meet the shortfall. For longer-term considerations, 3D printing may not compare well with injection molding as a production method due to the challenging scalability and greater production costs of 3D printing.
To secure sufficient nasopharyngeal swab availability for our national healthcare system, we designed a novel injection molded nasopharyngeal swab (the IM2 swab). We performed a clinical diagnostic study comparing the IM2 swab to the Copan FLOQSwab. Forty patients with a known diagnosis of COVID-19 and 10 healthy controls were recruited. Paired nasopharyngeal swabs were obtained from the same nostril of each participant and tested for SARS-CoV-2 by RT-PCR.
When compared to the Copan FLOQswab, results from the IM2 swab displayed excellent overall agreement and positive percent agreement of 96.0% and 94.9%, respectively. There was no significant difference in mean RT-PCR cycle threshold values for the ORF1ab (28.05 vs. 28.03, p = 0.97) and E-gene (29.72 vs. 29.37, p = 0.64) targets, respectively. We did not observe any significant adverse events and there was no significant difference in patient-reported pain.
In summary, the IM2 nasopharyngeal swab is a clinically safe, highly accurate option to commercial nasopharyngeal swabs.
目前,新冠病毒病(COVID-19)诊断的金标准是实时逆转录聚合酶链反应(RT-PCR)检测严重急性呼吸综合征冠状病毒2(SARS-CoV-2)。这通常通过鼻咽拭子采集的呼吸道分泌物进行检测。由于供应链限制以及全球范围内因COVID-19大流行导致的高需求,商用鼻咽拭子的供应无法得到保证。3D打印方法已被用于弥补短缺。从长期考虑,由于3D打印具有挑战性的可扩展性和更高的生产成本,作为一种生产方法,它可能无法与注塑成型相媲美。
为了确保我国医疗系统有足够的鼻咽拭子供应,我们设计了一种新型注塑成型鼻咽拭子(IM2拭子)。我们进行了一项临床诊断研究,将IM2拭子与科盼(Copan)FLOQSwab拭子进行比较。招募了40例确诊为COVID-19的患者和10名健康对照。从每个参与者的同一鼻孔采集配对的鼻咽拭子,并通过RT-PCR检测SARS-CoV-2。
与科盼FLOQSwab拭子相比,IM2拭子的结果显示出总体一致性良好,阳性百分比一致性分别为96.0%和94.9%。开放阅读框1ab(ORF1ab)(28.05对28.03,p = 0.97)和E基因(29.72对29.37,p = 0.64)靶点的平均RT-PCR循环阈值没有显著差异。我们未观察到任何显著的不良事件,患者报告的疼痛也没有显著差异。
总之,IM2鼻咽拭子是一种临床安全、准确性高的商用鼻咽拭子替代品。