Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study.
Evaluating Specimen Quality and Results from a Community-Wide, Home-Based Respiratory Surveillance Study.
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DOI：
10.1128/jcm.02934-20
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发表时间：
2021-04-20
影响因子：
9.4
通讯作者：
Chu HY
中科院分区：
文献类型：
--
作者：
Kim AE;Brandstetter E;Wilcox N;Heimonen J;Graham C;Han PD;Starita LM;McCulloch DJ;Casto AM;Nickerson DA;Van de Loo MM;Mooney J;Ilcisin M;Fay KA;Lee J;Sibley TR;Lyon V;Geyer RE;Thompson M;Lutz BR;Rieder MJ;Bedford T;Boeckh M;Englund JA;Chu HY
虽然流感和其他呼吸道病原体会导致严重的发病率和死亡率，但这些感染在社区造成的负担仍然不完全清楚。开发检测呼吸道感染的新方法对于减轻流行病和发展大流行防备基础设施至关重要。虽然流感和其他呼吸道病原体会导致严重的发病率和死亡率，但这些感染在社区造成的负担仍然不完全清楚。开发检测呼吸道感染的新方法对于减轻流行病和发展大流行防备基础设施至关重要。从2019年10月到2020年3月，我们利用电子同意和数据收集工具，在华盛顿州大西雅图地区进行了一项以家庭为基础的横断面研究。参与者在自我报告呼吸道症状后24小时内通过快速递送接受鼻拭子收集试剂盒。样本被送回实验室，并对26种呼吸道病原体和一种管家基因进行了筛查。在样本收集时和1周后通过在线调查记录参与者的数据。在4572名同意的参与者中，4359人(95.3%)接受了家庭拭子试剂盒，3648人(83.7%)返回了鼻部样本进行呼吸道病原体筛查。3638个可检测样本的平均RNaseP相对周期阈值(CRT)值为19.0(SD，3.4)，1,232个(33.9%)样本对一种或多种病原体呈阳性结果，其中645个(17.7%)样本为流感阳性。在可检测的样本中，从运送家庭拭子试剂盒到完成实验室检测的中位数时间为8.0IQR日(四分位数范围为7.0IQR14.0)。只发生一次不良事件，没有造成长期影响，也不需要医疗护理。通过在线参与者登记和样本自我采集进行基于家庭的监测是一种安全可行的方法，可在社区一级监测流感和其他呼吸道病原体，这些监测方法很容易适应大流行期间的使用。
While influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure. While influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure. From October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle, WA, area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a housekeeping gene. Participant data were recorded via online survey at the time of sample collection and 1 week later. Of the 4,572 consented participants, 4,359 (95.3%) received a home swab kit and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P relative cycle threshold (Crt) value of 19.0 (SD, 3.4), and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8.0 days (interquartile range [IQR], 7.0 to 14.0). A single adverse event occurred and did not cause long-term effects or require medical attention. Home-based surveillance using online participant enrollment and specimen self-collection is a safe and feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.