Sample pooling is a viable strategy for SARS-CoV-2 detection in low-prevalence settings.
Sample pooling is a viable strategy for SARS-CoV-2 detection in low-prevalence settings.
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DOI：
10.1016/j.pathol.2020.09.005
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发表时间：
2020-12
期刊：
影响因子：
4.5
通讯作者：
Catton M
中科院分区：
文献类型：
--
作者：
Chong BSW;Tran T;Druce J;Ballard SA;Simpson JA;Catton M
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的大流行大大增加了对实验室产量和核酸提取和聚合酶链式反应(PCR)试剂的需求。试剂短缺可能会限制缩减遏制措施所需检测的扩大。这项研究的目的是调查样本合并作为一种增加检测吞吐量和保存PCR试剂的策略的可行性；并报告我们在临床样本合并方面的早期经验。一项实施前的研究评估了两个、四个和八个样本库在基于实时逆转录聚合酶链式反应的工作流程中的敏感性和理论效率。在需求高峰期，两个实验室制定并实施了标准操作程序，其中包括在我们实验室处理的29,000多个临床样本。灵敏度降低(对于两个、四个和八个样本的池，周期阈值的平均绝对值分别增加0.6、2.3和3.0)，效率随着池大小的增加而增加。在疾病高患病率的情况下，从汇集中获得的收益减少。我们的标准操作程序已在两个实验室成功实施。更复杂的工作流程会带来更高的出错风险，并且需要风险缓解策略。个别样品的周转时间增加，因此紧急样品不应混合在一起。对于在低流行率环境中进行SARS-CoV-2的高通量检测，汇集是一种可行的策略。
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has significantly increased demand on laboratory throughput and reagents for nucleic acid extraction and polymerase chain reaction (PCR). Reagent shortages may limit the expansion of testing required to scale back containment measures. The aims of this study were to investigate the viability of sample pooling as a strategy for increasing test throughput and conserving PCR reagents; and to report our early experience with pooling of clinical samples. A pre-implementation study was performed to assess the sensitivity and theoretical efficiency of two, four, and eight-sample pools in a real-time reverse transcription PCR-based workflow. A standard operating procedure was developed and implemented in two laboratories during periods of peak demand, inclusive of over 29,000 clinical samples processed in our laboratory. Sensitivity decreased (mean absolute increase in cycle threshold value of 0.6, 2.3, and 3.0 for pools of two, four, and eight samples, respectively) and efficiency increased as pool size increased. Gains from pooling diminished at high disease prevalence. Our standard operating procedure was successfully implemented across two laboratories. Increased workflow complexity imparts a higher risk of errors, and requires risk mitigation strategies. Turnaround time for individual samples increased, hence urgent samples should not be pooled. Pooling is a viable strategy for high-throughput testing of SARS-CoV-2 in low-prevalence settings.
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