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Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic
The COVID-19 pandemic created the need for large-scale testing of populations. However, most laboratories do not have sufficient testing capacity for mass screening. We evaluated pooled testing of samples, as a strategy to increase testing capacity in Lao PDR. Samples of consecutive patients were te...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9522287/ https://www.ncbi.nlm.nih.gov/pubmed/36173954 http://dx.doi.org/10.1371/journal.pone.0275294 |
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author | Iem, Vibol Xangsayarath, Phonepadith Chittamany, Phonenaly Suthepmany, Sakhone Siphanthong, Souvimone Paboriboune, Phimpha Somphavong, Silaphet Konstantina, Kontogianni Khan, Jahangir A. M. Edwards, Thomas Wingfield, Tom Creswell, Jacob Dominguez, Jose Cuevas, Luis E. |
author_facet | Iem, Vibol Xangsayarath, Phonepadith Chittamany, Phonenaly Suthepmany, Sakhone Siphanthong, Souvimone Paboriboune, Phimpha Somphavong, Silaphet Konstantina, Kontogianni Khan, Jahangir A. M. Edwards, Thomas Wingfield, Tom Creswell, Jacob Dominguez, Jose Cuevas, Luis E. |
author_sort | Iem, Vibol |
collection | PubMed |
description | The COVID-19 pandemic created the need for large-scale testing of populations. However, most laboratories do not have sufficient testing capacity for mass screening. We evaluated pooled testing of samples, as a strategy to increase testing capacity in Lao PDR. Samples of consecutive patients were tested in pools of four using the Xpert Xpress SARS CoV-2 assay. Positive pools were confirmed by individual testing, and we describe the performance of the test and savings achieved. We also diluted selected positive samples to describe its effect on the assays CT values. 1,568 patients were tested in 392 pools of four. 361 (92.1%) pools were negative and 31 (7.9%) positive. 29/31 (93.5% (95%CI 77–99%) positive pools were confirmed by individual testing of the samples but, in 2/31 (6.5%) the four individual samples were negative, suggesting contamination. Pools with only one positive sample had higher CT values (lower RNA concentrations) than the respective individual samples, indicating a dilution effect, which suggested an increased risk of false negative results with dilutions >1:10. However, this risk may be low if the prevalence of infection is high, when pools are more likely to contain more than one positive sample. Pooling saved 67% of cartridges and substantially increased testing capacity. Pooling samples increased SARS-CoV-2 testing capacity and resulted in considerable cartridge savings. Given the need for high-volume testing, countries may consider implementation of pooling for SARS-CoV-2 screening. |
format | Online Article Text |
id | pubmed-9522287 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-95222872022-09-30 Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic Iem, Vibol Xangsayarath, Phonepadith Chittamany, Phonenaly Suthepmany, Sakhone Siphanthong, Souvimone Paboriboune, Phimpha Somphavong, Silaphet Konstantina, Kontogianni Khan, Jahangir A. M. Edwards, Thomas Wingfield, Tom Creswell, Jacob Dominguez, Jose Cuevas, Luis E. PLoS One Research Article The COVID-19 pandemic created the need for large-scale testing of populations. However, most laboratories do not have sufficient testing capacity for mass screening. We evaluated pooled testing of samples, as a strategy to increase testing capacity in Lao PDR. Samples of consecutive patients were tested in pools of four using the Xpert Xpress SARS CoV-2 assay. Positive pools were confirmed by individual testing, and we describe the performance of the test and savings achieved. We also diluted selected positive samples to describe its effect on the assays CT values. 1,568 patients were tested in 392 pools of four. 361 (92.1%) pools were negative and 31 (7.9%) positive. 29/31 (93.5% (95%CI 77–99%) positive pools were confirmed by individual testing of the samples but, in 2/31 (6.5%) the four individual samples were negative, suggesting contamination. Pools with only one positive sample had higher CT values (lower RNA concentrations) than the respective individual samples, indicating a dilution effect, which suggested an increased risk of false negative results with dilutions >1:10. However, this risk may be low if the prevalence of infection is high, when pools are more likely to contain more than one positive sample. Pooling saved 67% of cartridges and substantially increased testing capacity. Pooling samples increased SARS-CoV-2 testing capacity and resulted in considerable cartridge savings. Given the need for high-volume testing, countries may consider implementation of pooling for SARS-CoV-2 screening. Public Library of Science 2022-09-29 /pmc/articles/PMC9522287/ /pubmed/36173954 http://dx.doi.org/10.1371/journal.pone.0275294 Text en © 2022 Iem et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Iem, Vibol Xangsayarath, Phonepadith Chittamany, Phonenaly Suthepmany, Sakhone Siphanthong, Souvimone Paboriboune, Phimpha Somphavong, Silaphet Konstantina, Kontogianni Khan, Jahangir A. M. Edwards, Thomas Wingfield, Tom Creswell, Jacob Dominguez, Jose Cuevas, Luis E. Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic |
title | Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic |
title_full | Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic |
title_fullStr | Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic |
title_full_unstemmed | Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic |
title_short | Pooling samples to increase testing capacity with Xpert Xpress SARS-CoV-2 during the Covid-19 pandemic in Lao People’s Democratic Republic |
title_sort | pooling samples to increase testing capacity with xpert xpress sars-cov-2 during the covid-19 pandemic in lao people’s democratic republic |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9522287/ https://www.ncbi.nlm.nih.gov/pubmed/36173954 http://dx.doi.org/10.1371/journal.pone.0275294 |
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