Division of Microbiology, Department of Pathology and Laboratory Medicine, Nova Scotia Health, Halifax, Nova Scotia, Canada; Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada; Departments of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; Departments of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada.
Provincial Public Health Laboratory Network of Nova Scotia (PPHLN), Halifax, Nova Scotia, Canada.
J Virol Methods. 2021 Sep;295:114184. doi: 10.1016/j.jviromet.2021.114184. Epub 2021 May 23.
With increasing demands for SARS-CoV-2 testing, as well as the shortages for testing supplies, collection devices, and trained healthcare workers (HCWs) to collect specimens, self-collection is an attractive prospect to reduce the need for HCWs and expenditure of personal protective equipment. Apart from the traditional nasopharyngeal swab used for SARS-CoV-2 detection, alternative specimens have been validated such as a combined swabs of the oropharynx and anterior nares (OP/N), or throat samples using saline gargles. Both the alternative specimen types are amenable to self-collection. Objectives. This study aimed to compare the sensitivity of HCW-collected (OP/N) swabs, self-collected OP/N swabs, and self-collected saline gargles. Among 38 individuals previously testing positive for SARS-CoV-2 (or their close contacts), two self-collected specimen types (OP/N and saline gargles) were compared to HCW-collected OP/N swabs. SARS-CoV-2 testing was performed on three molecular assays: a laboratory-developed test (LDT), and two commercial assays on automated platforms: Cobas 6800 (Roche Diagnostics) and Panther (Hologic). The sensitivity of self-collected OP/N swabs was equivalent to healthcare worker (HCW)-collected OP/N swabs at 100.0 % [92.6%-100.0%] for all three molecular tests. The sensitivity of saline gargles was not significantly different than HCW-collected OP/N swabs, but varied slightly between instruments at 93.8 % [85.9%-93.8%] for the LDT, 96.8 % [88.6%-96.8%] for the Cobas assay, and 96.7 % [89.2%-96.9%] for the Panther assay. Overall, self-collection using OP/N swabs or saline gargles are reasonable alternatives to HCW-based collections for SARS-CoV-2 detection, and could facilitate broader surveillance strategies.
随着对 SARS-CoV-2 检测需求的增加，以及检测用品、采集设备和采集标本的训练有素的医护人员 (HCW) 的短缺，自我采集是减少 HCW 需求和个人防护设备支出的有吸引力的选择。除了用于 SARS-CoV-2 检测的传统鼻咽拭子外，还已经验证了替代标本，例如口咽和前鼻 (OP/N) 的联合拭子，或使用盐水漱口的咽喉样本。这两种替代标本类型都适合自我采集。目的。本研究旨在比较 HCW 采集的 (OP/N) 拭子、自我采集的 OP/N 拭子和自我采集的盐水漱口液的敏感性。在 38 名先前 SARS-CoV-2 检测阳性的个体（或其密切接触者）中，两种自我采集的标本类型（OP/N 和盐水漱口液）与 HCW 采集的 OP/N 拭子进行了比较。SARS-CoV-2 检测在三种分子检测方法上进行：实验室开发的检测 (LDT)，以及两种在自动化平台上的商业检测：Cobas 6800（罗氏诊断）和 Panther（豪洛捷）。自我采集的 OP/N 拭子的敏感性与 HCW 采集的 OP/N 拭子相当，在所有三种分子检测中均为 100.0% [92.6%-100.0%]。盐水漱口液的敏感性与 HCW 采集的 OP/N 拭子无显著差异，但在仪器之间略有差异，LDT 为 93.8% [85.9%-93.8%]，Cobas 检测为 96.8% [88.6%-96.8%]， Panther 检测为 96.7% [89.2%-96.9%]。总体而言，使用 OP/N 拭子或盐水漱口液进行自我采集是 SARS-CoV-2 检测替代 HCW 采集的合理选择，并且可以促进更广泛的监测策略。
