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多中心 SARS-CoV-2 抗原即时检测用于无症状长期护理机构工作人员筛查的阳性预测值的实施后评估。

Multicenter Postimplementation Assessment of the Positive Predictive Value of SARS-CoV-2 Antigen-Based Point-of-Care Tests Used for Screening of Asymptomatic Continuing Care Staff.

机构信息

Division of Infectious Diseases, Department of Medicine, University of Calgarygrid.22072.35 School of Medicine, Calgary Alberta, Canada.

Public Health Laboratory, Alberta Precision Laboratories, Alberta, Canada.

出版信息

J Clin Microbiol. 2021 Oct 19;59(11):e0141121. doi: 10.1128/JCM.01411-21. Epub 2021 Jul 21.

DOI:10.1128/JCM.01411-21
PMID:34288728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8525574/
Abstract

Frequent screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic populations using antigen-based point-of-care tests (APOCTs) is occurring globally with limited clinical performance data. The positive predictive value (PPV) of two APOCTs used in the asymptomatic screening of SARS-CoV-2 among health care workers (HCWs) at continuing care (CC) sites across AB, Canada, was evaluated. Between 22 February and 2 May 2021, CC sites implemented SARS-CoV-2 voluntary screening of their asymptomatic HCWs. On-site testing with Abbott Panbio or BD Veritor occurred on a weekly or twice-weekly basis. Positive APOCTs were confirmed with a real-time reverse transcriptase PCR (rRT-PCR) reference method. A total of 71,847 APOCTs (17,689 Veritor and 54,158 Panbio) were performed among 369 CC sites. Eighty-seven (0.12%) APOCTs were positive, of which 39 (0.05%) were confirmed as true positives using rRT-PCR. Use of the Veritor and Panbio resulted in 76.6% and 30.0% false-positive detection, respectively ( < 0.001). This corresponded to PPVs of 23.4 and 70.0% for the Veritor and Panbio, respectively. Frequent screening of SARS-CoV-2 among asymptomatic HCWs in CC, using APOCTs, resulted in a very low detection rate and a high rate of detection of false positives. Careful assessment of the risks versus benefits of APOCT programs and the prevalence of infection in this population needs to be thoroughly considered before implementation.

摘要

对无症状人群进行频繁的严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 筛查,使用抗原为基础的即时检测(APOCT),这在全球范围内都在进行,但其临床性能数据有限。在加拿大 AB 省的持续护理(CC)场所对两种用于无症状 SARS-CoV-2 筛查的 APOCT 的阳性预测值(PPV)进行了评估。在 2021 年 2 月 22 日至 5 月 2 日期间,CC 场所对其无症状的医护人员(HCW)进行了 SARS-CoV-2 自愿筛查。现场检测使用 Abbott Panbio 或 BD Veritor,每周或每两周进行一次。阳性 APOCT 采用实时逆转录酶 PCR(rRT-PCR)参考方法进行确认。在 369 个 CC 场所进行了总共 71847 次 APOCT(17689 次 Veritor 和 54158 次 Panbio)。87 次(0.12%)APOCT 检测结果呈阳性,其中 39 次(0.05%)经 rRT-PCR 确认为真阳性。Veritor 和 Panbio 的假阳性检出率分别为 76.6%和 30.0%(<0.001)。这对应于 Veritor 和 Panbio 的 PPV 分别为 23.4%和 70.0%。在 CC 中对无症状的 HCW 进行频繁的 SARS-CoV-2 筛查,使用 APOCT,结果发现检测率非常低,假阳性检出率很高。在实施之前,需要仔细评估 APOCT 计划的风险与效益以及该人群的感染率。

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