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Volume 70, Issue 9

Editor's Choice Sample collection and transport strategies to enhance yield, accessibility, and biosafety of COVID-19 RT-PCR testing Open Access

Abstract

Non-invasive sample collection and viral sterilizing buffers have independently enabled workflows for more widespread COVID-19 testing by reverse-transcriptase polymerase chain reaction (RT-PCR).

The combined use of sterilizing buffers across non-invasive sample types to optimize sensitive, accessible, and biosafe sampling methods has not been directly and systematically compared.

We aimed to evaluate diagnostic yield across different non-invasive samples with standard viral transport media (VTM) versus a sterilizing buffer eNAT- (Copan diagnostics Murrieta, CA) in a point-of-care diagnostic assay system.

We prospectively collected 84 sets of nasal swabs, oral swabs, and saliva, from 52 COVID-19 RT-PCR-confirmed patients, and nasopharyngeal (NP) swabs from 37 patients. Nasal swabs, oral swabs, and saliva were placed in either VTM or eNAT, prior to testing with the Xpert Xpress SARS-CoV-2 (Xpert). The sensitivity of each sampling strategy was compared using a composite positive standard.

Swab specimens collected in eNAT showed an overall superior sensitivity compared to swabs in VTM (70 % vs 57 %, =0.0022). Direct saliva 90.5 %, (95 % CI: 82 %, 95 %), followed by NP swabs in VTM and saliva in eNAT, was significantly more sensitive than nasal swabs in VTM (50 %, <0.001) or eNAT (67.8 %, =0.0012) and oral swabs in VTM (50 %, <0.0001) or eNAT (58 %, <0.0001). Saliva and use of eNAT buffer each increased detection of SARS-CoV-2 with the Xpert; however, no single sample matrix identified all positive cases.

Saliva and eNAT sterilizing buffer can enhance safe and sensitive detection of COVID-19 using point-of-care GeneXpert instruments.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): eNAT , Inactivation , Nasal , Oral and Saliva
Funding
This study was supported by the:
  • Rutgers, The State University of New Jersey (Award CCRP2)
    • Principle Award Recipient: YingdaL Xie
  • National Institute of Allergy and Infectious Diseases (Award R01 AI131617)
    • Principle Award Recipient: DavidAlland
© 2021 The Authors
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. The Microbiology Society waived the open access fees for this article.
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2021-09-06
2024-04-19
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Sample collection and transport strategies to enhance yield, accessibility, and biosafety of COVID-19 RT-PCR testing
J. Med. Microbiol. 70, 001380 (2021); https://doi.org/10.1099/jmm.0.001380
/content/journal/jmm/10.1099/jmm.0.001380
/content/journal/jmm/10.1099/jmm.0.001380
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