Evaluation of saliva pools method for detection of congenital human cytomegalovirus infection

Silva, Julieta; Fernandes, Cláudia Lemelle; Marques, Augusta; María, Ana; Correia, Cátia; Tuna, Madalena; Chasqueira, Maria Jesus; Paixão, Paulo

doi:10.1016/j.jviromet.2019.113759

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…One of the main critiques to the pool testing strategy , is the dilution that occurs when pooling the samples together, and how this dilution might affect the test sensitivity. Previous studies have shown that there is no decrease in sensitivity for RT‐PCR in detecting other viruses when using pool samples of 10 and 20 subjects, 30 however, as far as the available evidence on SARS‐CoV‐2 show, samples of five subjects do not affect sensibility of RT‐PCR for detecting the virus 24…”

Section: Resultsmentioning

confidence: 89%

Optimization of group size in pool testing strategy for SARS‐CoV‐2: A simple mathematical model

Aragón‐Caqueo

Fernández-Salinas

Laroze

2020

Journal of Medical Virology

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Coronavirus disease has reached unprecedented pandemic levels and is affecting almost every country in the world. Ramping up the testing capacity of a country supposes an essential public health response to this new outbreak. A pool testing strategy where multiple samples are tested in a single reverse transcriptasepolymerase chain reaction (RT-PCR) kit could potentially increase a country's testing capacity. The aim of this study is to propose a simple mathematical model to estimate the optimum number of pooled samples according to the relative prevalence of positive tests in a particular healthcare context, assuming that if a group tests negative, no further testing is done whereas if a group tests positive, all the subjects of the group are retested individually. The model predicts group sizes that range from 11 to 3 subjects. For a prevalence of 10% of positive tests, 40.6% of tests can be saved using testing groups of four subjects. For a 20% prevalence, 17.9% of tests can be saved using groups of three subjects. For higher prevalences, the strategy flattens and loses effectiveness. Pool testing individuals for severe acute respiratory syndrome coronavirus 2 is a valuable strategy that could considerably boost a country's testing capacity. However, further studies are needed to address how large these groups can be, without losing sensitivity on the RT-PCR. The strategy best works in settings with a low prevalence of positive tests. It is best implemented in subgroups with low clinical suspicion. The model can be adapted to specific prevalences, generating a tailored to the context implementation of the pool testing strategy. K E Y W O R D Scoronavirus, modeling, pool testing, public health, strategy

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Section: Resultsmentioning

confidence: 89%

Optimization of group size in pool testing strategy for SARS‐CoV‐2: A simple mathematical model

Aragón‐Caqueo

Fernández-Salinas

Laroze

2020

Journal of Medical Virology

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“…Genomic DNA was extracted using the Purelink Genomic DNA commercial kit (Invitrogen, Carlsbad, USA), according to the manufacturer's instructions and stored at − 20°C until use. HCMV DNA was amplified and detected by qPCR on the Applied Biosystems 7500 Fast Real-Time PCR System (Applied Biosystems, Foster City, USA) using an "in-house" method, detailed elsewhere, with 100% sensitivity and specificity when compared with individual samples [13,20]. Each pool was tested according to the algorithm described in Fig.…”

Section: Methodsmentioning

confidence: 99%

“…The possibility of implementing a screening program using saliva samples has been studied in recent years, as saliva is much simpler to collect [16][17][18][19]. A recent study in our laboratory has shown that the real-time PCR technique using saliva pools has high sensitivity and specificity (100%) when compared with single sample testing and could easily be applied to large-scale studies, enabling the identification of most newborns with congenital HCMV infection at a significantly reduced cost [20].…”

Section: Introductionmentioning

confidence: 99%

Saliva pools for screening of human cytomegalovirus using real-time PCR

et al. 2020

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Human cytomegalovirus (HCMV) is the leading congenital infection agent in the world. The importance of screening this infection has been debated, as 10–15% of the asymptomatic newborns with HCMV at birth will present late sequelae. The aim of this study was to test the feasibility of using saliva pools from newborns in a screening program for congenital HCMV infection, in two Portuguese hospitals. The screening was based on the use of pools of 10 saliva samples for detection of viral DNA by real-time PCR. Whenever there was a positive pool, the samples were tested individually, and for each positive sample the result was confirmed with a urine sample collected in the first 2 weeks of life. The study involved 1492 newborns. One hundred and fifty pools were screened, with 14 positive results in saliva, but only 10 were confirmed in urine samples, giving a prevalence of congenital HCMV infection in both hospitals of 0.67% (CI95% 0.36 to 1.23%). Conclusion: The overall prevalence of congenital HCMV infection in both hospitals was 0.67%. The use of saliva pools proved to be effective for the screening of this congenital infection, allowing timely screening and confirmation in a large population, with associated cost reduction. What is Known:• Newborn screening for HCMV is desirable.• Saliva is a good and practical sample. What is New:• The feasibility of using saliva pools for a large-scale screening.• The cost reduction of this strategy.

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“…The effects of the COVID-19 lockdown on decreasing incidence of various communicable diseases in children have been discussed recently, but congenital CMV was not addressed [8]. Therefore, the aim of our study was to compare the 2020 prevalence of the congenital infection in four Portuguese hospitals (using a screening program with a pool strategy previously tested with saliva samples) [9], with the prevalence found in a 2019 cohort, before the pandemic period [10].…”

Section: Introductionmentioning

confidence: 99%

Lower prevalence of congenital cytomegalovirus infection in Portugal: possible impact of COVID-19 lockdown?

et al. 2021

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Cytomegalovirus (CMV) is the most frequent cause of congenital infection all over the world. Its prevalence ranges from 0.2 to 2.2%. Transmission from children to their pregnant mothers is a well-known risk factor, particularly if they attend a childcare centre. This study aims to compare the prevalence of CMV congenital infection (CMV_CI) in Portugal (Lisbon) between two studies, performed respectively in 2019 and 2020. In the 2019 study, performed in two hospitals, we found a 0.67% CMV_CI prevalence, using a pool strategy previously tested with saliva samples. In the 2020 study, using the same pool approach in four hospitals (the previous and two additional), and based on 1277 samples, the prevalence was 0.078%. Conclusion:The close temporal coincidence with COVID-19 lockdown suggests that these measures may have had a significant impact on this reduction, although other explanations cannot be ruled-out. What is Known:• Cytomegalovirus is the leading cause of congenital infection.• Behavioural measures decrease cytomegalovirus seroconversion in pregnant women.

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Evaluation of saliva pools method for detection of congenital human cytomegalovirus infection

Cited by 11 publications

References 19 publications

Optimization of group size in pool testing strategy for SARS‐CoV‐2: A simple mathematical model

Optimization of group size in pool testing strategy for SARS‐CoV‐2: A simple mathematical model

Saliva pools for screening of human cytomegalovirus using real-time PCR

Lower prevalence of congenital cytomegalovirus infection in Portugal: possible impact of COVID-19 lockdown?

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