A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community.
A Sensitive and Rapid Wastewater Test for SARS-COV-2 and Its Use for the Early Detection of a Cluster of Cases in a Remote Community.
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DOI：
10.1128/aem.01740-21
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发表时间：
2022-03-08
影响因子：
4.4
通讯作者：
Becker MG
中科院分区：
文献类型：
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作者：
Daigle J;Racher K;Hazenberg J;Yeoman A;Hannah H;Duong D;Mohammed U;Spreitzer D;Gregorchuk BSJ;Head BM;Meyers AFA;Sandstrom PA;Nichani A;Brooks JI;Mulvey MR;Mangat CS;Becker MG
在2019冠状病毒病（COVID-19）大流行期间，废水监测一直用于监测社区严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）的流行趋势。建立废水监测方案的一个主要挑战，特别是在偏远地区，是需要一个设备齐全的样品分析实验室。目前，还没有快速、灵敏、移动的和易于使用的SARS-CoV-2废水检测方法。使用废水作为输入，对GeneXpert系统的性能进行了评估，该系统在便携式平台上提供了基于凝胶的SARS-CoV-2快速分子临床检测。GeneXpert证明废水中SARS-CoV-2的检测限低于32拷贝/mL，样本处理时间不到1小时。使用2021年2月和3月期间从加拿大多个地点收集的废水样本，观察到GeneXpert检测试剂盒与实验室开发的检测试剂盒在是否存在SARS-CoV-2方面的总体一致性较高（97.8%）。此外，通过使用离心过滤器，GeneXpert系统在废水中的检测阈值提高到<10拷贝/mL。最后，为了支持现场废水监测，在加拿大北方的偏远社区耶洛奈夫实施了GeneXpert检测，该检测成功提醒公共卫生当局注意未被发现的COVID-19传播。在废水中发现SARS-CoV-2引发了对近期旅行者的临床检测，并发现了新的COVID-19病例/集群。综上所述，这些结果表明，GeneXpert是一个可行的选择，监测废水中的SARS-CoV-2在没有获得既定的检测实验室的地方。重要性-基于水的监测是一种强有力的工具，可提供社区COVID-19患病率的公正衡量。这项工作描述了一种灵敏的废水快速检测SARS-CoV-2的基础上广泛分布的技术，GeneXpert。易于使用的SARS-CoV-2废水测试的优势是显而易见的：它支持偏远社区的监测，改善测试的可及性，并提供更快的结果，从而可以立即做出公共卫生反应。在偏远社区应用废水快速检测有助于发现COVID-19聚集并引发公共卫生行动，清楚地表明了这项技术的实用性。在疫苗接种后的大流行中，废水监测将变得越来越重要，因为无症状/轻度感染者继续传播SARS-CoV-2，但不太可能进行检测。
Throughout the coronavirus disease 2019 (COVID-19) pandemic, wastewater surveillance has been used to monitor trends in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence in the community. A major challenge in establishing wastewater surveillance programs, especially in remote areas, is the need for a well-equipped laboratory for sample analysis. Currently, no options exist for rapid, sensitive, mobile, and easy-to-use wastewater tests for SARS-CoV-2. The performance of the GeneXpert system, which offers cartridge-based, rapid molecular clinical testing for SARS-CoV-2 in a portable platform, was evaluated using wastewater as the input. The GeneXpert demonstrated a SARS-CoV-2 limit of detection in wastewater below 32 copies/mL with a sample processing time of less than an hour. Using wastewater samples collected from multiple sites across Canada during February and March 2021, a high overall agreement (97.8%) was observed between the GeneXpert assay and laboratory-developed tests regarding the presence or absence of SARS-CoV-2. Additionally, with the use of centrifugal filters, the detection threshold of the GeneXpert system was improved to <10 copies/mL in wastewater. Finally, to support on-site wastewater surveillance, GeneXpert testing was implemented in Yellowknife, a remote community in Northern Canada, where its use successfully alerted public health authorities to undetected transmission of COVID-19. The identification of SARS-CoV-2 in wastewater triggered clinical testing of recent travelers and identification of new COVID-19 cases/clusters. Taken together, these results suggest that GeneXpert is a viable option for surveillance of SARS-CoV-2 in wastewater in locations that do not have access to established testing laboratories. IMPORTANCE Wastewater-based surveillance is a powerful tool that provides an unbiased measure of COVID-19 prevalence in a community. This work describes a sensitive wastewater rapid test for SARS-CoV-2 based on a widely distributed technology, the GeneXpert. The advantages of an easy-to-use wastewater test for SARS-CoV-2 are clear: it supports surveillance in remote communities, improves access to testing, and provides faster results allowing for an immediate public health response. The application of wastewater rapid testing in a remote community facilitated the detection of a COVID-19 cluster and triggered public health action, clearly demonstrating the utility of this technology. Wastewater surveillance will become increasingly important in the postvaccination pandemic landscape as individuals with asymptomatic/mild infections continue transmitting SARS-CoV-2 but are unlikely to be tested.