Gargle pool PCR testing in a hospital during medium and high SARS-CoV-2 incidence.


Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Sep 2022
Historique:
received: 13 04 2022
revised: 24 05 2022
accepted: 24 05 2022
pubmed: 8 6 2022
medline: 14 9 2022
entrez: 7 6 2022
Statut: ppublish

Résumé

Hospitals need to be protected from SARS-CoV-2 infections to protect vulnerable patients. Thus, a safe, efficient, and cost-effective SARS-CoV-2 testing system for hospitals, in addition to standard hygiene measures and vaccination of staff, is necessary. Here we report on the feasibility and performance of a pool real-time reverse-transcriptase polymerase-chain-reaction (rRT-PCR) test system at, medium and high incidence. We implemented a testing concept based on gargling at home and pooling of samples in the hospital before PCR testing in the laboratory. We used two PCR systems (point of care and standard 96-well plate system) to adapt to challenges in the hospital setting and respond to a rising incidence in the Omicron wave. During our 10-week study period, we performed 697 pool PCRs (8793 tests in total) and identified 65 asymptomatic staff members by pool PCR and 94 symptomatic staff members by positive individual PCR. Virus loads in those detected by pool testing were significantly lower (P<0.001). The test system remained workable even during the peak of the Omicron wave and no outbreaks occurred in any specific area of the hospital during the study period. Unvaccinated individuals were over-represented in the positively tested (37% vs 22% positive tests, P=0.04). The test procedure was well accepted by a majority of the hospital staff (84%). Repeated gargle pool rRT-PCR testing can be implemented quickly in hospitals and is an effective, easily adaptable and well-accepted test system for hospitals, even during phases with very high infection rates.

Sections du résumé

BACKGROUND BACKGROUND
Hospitals need to be protected from SARS-CoV-2 infections to protect vulnerable patients. Thus, a safe, efficient, and cost-effective SARS-CoV-2 testing system for hospitals, in addition to standard hygiene measures and vaccination of staff, is necessary. Here we report on the feasibility and performance of a pool real-time reverse-transcriptase polymerase-chain-reaction (rRT-PCR) test system at, medium and high incidence.
METHODS METHODS
We implemented a testing concept based on gargling at home and pooling of samples in the hospital before PCR testing in the laboratory. We used two PCR systems (point of care and standard 96-well plate system) to adapt to challenges in the hospital setting and respond to a rising incidence in the Omicron wave.
FINDINGS RESULTS
During our 10-week study period, we performed 697 pool PCRs (8793 tests in total) and identified 65 asymptomatic staff members by pool PCR and 94 symptomatic staff members by positive individual PCR. Virus loads in those detected by pool testing were significantly lower (P<0.001). The test system remained workable even during the peak of the Omicron wave and no outbreaks occurred in any specific area of the hospital during the study period. Unvaccinated individuals were over-represented in the positively tested (37% vs 22% positive tests, P=0.04). The test procedure was well accepted by a majority of the hospital staff (84%).
CONCLUSION CONCLUSIONS
Repeated gargle pool rRT-PCR testing can be implemented quickly in hospitals and is an effective, easily adaptable and well-accepted test system for hospitals, even during phases with very high infection rates.

Identifiants

pubmed: 35671860
pii: S0195-6701(22)00182-7
doi: 10.1016/j.jhin.2022.05.018
pmc: PMC9166272
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

69-76

Informations de copyright

Copyright © 2022. Published by Elsevier Ltd.

Auteurs

P Kheiroddin (P)

University Children's Hospital Regensburg (KUNO), St. Hedwig's Hospital of the Order of St. John and the University of Regensburg, Regensburg, Germany.

V D Gaertner (VD)

Newborn Research Zurich, University Hospital and University of Zurich, Zurich, Switzerland.

P Schöberl (P)

University Children's Hospital Regensburg (KUNO), St. Hedwig's Hospital of the Order of St. John and the University of Regensburg, Regensburg, Germany; Science and Innovation Campus Regensburg (WECARE), St. Hedwig's Hospital of the Order of St. John, Regensburg, Germany.

E Fischer (E)

University Children's Hospital Regensburg (KUNO), St. Hedwig's Hospital of the Order of St. John and the University of Regensburg, Regensburg, Germany.

J Niggel (J)

Maganamed Limited, Regensburg, Germany.

P Pagel (P)

Maganamed Limited, Regensburg, Germany.

B M J Lampl (BMJ)

Department of Public Health, City and County of Regensburg, Regensburg, Germany; Department of Epidemiology and Preventive Medicine, Faculty of Medicine, University of Regensburg, Germany.

A Ambrosch (A)

Institute of Laboratory Medicine, Microbiology and Hygiene, St. Hedwig's Hospital of the Order of St. John, Regensburg, Germany.

M Kabesch (M)

University Children's Hospital Regensburg (KUNO), St. Hedwig's Hospital of the Order of St. John and the University of Regensburg, Regensburg, Germany; Science and Innovation Campus Regensburg (WECARE), St. Hedwig's Hospital of the Order of St. John, Regensburg, Germany. Electronic address: michael.kabesch@barmherzige-regensburg.de.

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