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Optimal size of sample pooling for RNA pool testing: An avant-garde for scaling up severe acute respiratory syndrome coronavirus-2 testing.
Indian Journal of Medical Microbiology ( IF 1.4 ) Pub Date : 2020-01-01 , DOI: 10.4103/ijmm.ijmm_20_260 Arvind Khodare 1 , Abhishek Padhi 1 , Ekta Gupta 1 , Reshu Agarwal 1 , Shantanu Dubey 2 , Shiv Kumar Sarin 3
Background and Objectives: Timely diagnosis is essential for the containment of the disease and breaks in the chain of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The present situation demands the countries to scale up their testing and design innovative strategies to conserve diagnostic kits and reagents. The pooling of samples saves time, workforce and most importantly diagnostic kits and reagents. In the present study, we tried to define the pool size that could be applied with acceptable confidence for testing. Materials and Methods: We used repeatedly tested positive clinical sample elutes having different levels of SARS CoV 2 RNA and negative sample elutes to prepare seven series of 11 pools each, having pool sizes ranging from 2 to 48 samples to estimate the optimal pool size. Each pool had one positive sample elute in different compositions. All the pools were tested by SARS CoV 2 reverse transcriptase quantitative polymerase chain reaction. Results: Out of the 77 pools, only 53 (68.8%) were found positive. The sensitivity of pools of 2–48 samples was decreased from 100% (95% confidence interval [CL]; 98.4–100) to 41.41% (95% CL; 34.9–48.1). The maximum size of the pool with acceptable sensitivity (>95%) was found to be of six samples. For the pool size of six samples, the sensitivity was 97.8% and the efficiency of pooling was 0.38. Conclusions: The pooling of samples is a practical way for scaling up testing and ultimately containing the further spread of the CoV disease 2019 pandemic.
中文翻译：
RNA 池测试的样本池最佳大小：扩大严重急性呼吸综合征冠状病毒 2 测试规模的前卫。
背景和目标：及时诊断对于遏制该疾病和打破严重急性呼吸综合征冠状病毒（SARS-CoV-2）的传播链至关重要。当前的形势要求各国扩大检测规模并制定创新战略以节省诊断试剂盒和试剂。样本汇集可以节省时间、劳动力，最重要的是节省诊断试剂盒和试剂。在本研究中，我们试图定义可以以可接受的置信度进行测试的池大小。材料和方法：我们使用反复测试的具有不同水平 SARS CoV 2 RNA 的阳性临床样品洗脱物和阴性样品洗脱物来制备七个系列，每个系列 11 个池，池大小范围为 2 至 48 个样本，以估计最佳池大小。每个池都有一个以不同组合物洗脱的阳性样品。所有池均通过 SARS CoV 2 逆转录酶定量聚合酶链反应进行检测。结果：在 77 个池中，只有 53 个（68.8%）呈阳性。 2-48 个样本池的敏感性从 100%（95% 置信区间 [CL]；98.4-100）下降至 41.41%（95% CL；34.9-48.1）。发现具有可接受灵敏度 (>95%) 的最大池大小为六个样本。对于六个样本的池大小，灵敏度为 97.8%，池化效率为 0.38。结论：样本汇集是扩大检测规模并最终遏制 2019 年 CoV 疾病大流行进一步传播的实用方法。
更新日期：2020-01-01
Indian Journal of Medical Microbiology ( IF 1.4 ) Pub Date : 2020-01-01 , DOI: 10.4103/ijmm.ijmm_20_260 Arvind Khodare 1 , Abhishek Padhi 1 , Ekta Gupta 1 , Reshu Agarwal 1 , Shantanu Dubey 2 , Shiv Kumar Sarin 3
Affiliation
Background and Objectives: Timely diagnosis is essential for the containment of the disease and breaks in the chain of transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The present situation demands the countries to scale up their testing and design innovative strategies to conserve diagnostic kits and reagents. The pooling of samples saves time, workforce and most importantly diagnostic kits and reagents. In the present study, we tried to define the pool size that could be applied with acceptable confidence for testing. Materials and Methods: We used repeatedly tested positive clinical sample elutes having different levels of SARS CoV 2 RNA and negative sample elutes to prepare seven series of 11 pools each, having pool sizes ranging from 2 to 48 samples to estimate the optimal pool size. Each pool had one positive sample elute in different compositions. All the pools were tested by SARS CoV 2 reverse transcriptase quantitative polymerase chain reaction. Results: Out of the 77 pools, only 53 (68.8%) were found positive. The sensitivity of pools of 2–48 samples was decreased from 100% (95% confidence interval [CL]; 98.4–100) to 41.41% (95% CL; 34.9–48.1). The maximum size of the pool with acceptable sensitivity (>95%) was found to be of six samples. For the pool size of six samples, the sensitivity was 97.8% and the efficiency of pooling was 0.38. Conclusions: The pooling of samples is a practical way for scaling up testing and ultimately containing the further spread of the CoV disease 2019 pandemic.
中文翻译：
RNA 池测试的样本池最佳大小：扩大严重急性呼吸综合征冠状病毒 2 测试规模的前卫。
背景和目标：及时诊断对于遏制该疾病和打破严重急性呼吸综合征冠状病毒（SARS-CoV-2）的传播链至关重要。当前的形势要求各国扩大检测规模并制定创新战略以节省诊断试剂盒和试剂。样本汇集可以节省时间、劳动力，最重要的是节省诊断试剂盒和试剂。在本研究中，我们试图定义可以以可接受的置信度进行测试的池大小。材料和方法：我们使用反复测试的具有不同水平 SARS CoV 2 RNA 的阳性临床样品洗脱物和阴性样品洗脱物来制备七个系列，每个系列 11 个池，池大小范围为 2 至 48 个样本，以估计最佳池大小。每个池都有一个以不同组合物洗脱的阳性样品。所有池均通过 SARS CoV 2 逆转录酶定量聚合酶链反应进行检测。结果：在 77 个池中，只有 53 个（68.8%）呈阳性。 2-48 个样本池的敏感性从 100%（95% 置信区间 [CL]；98.4-100）下降至 41.41%（95% CL；34.9-48.1）。发现具有可接受灵敏度 (>95%) 的最大池大小为六个样本。对于六个样本的池大小，灵敏度为 97.8%，池化效率为 0.38。结论：样本汇集是扩大检测规模并最终遏制 2019 年 CoV 疾病大流行进一步传播的实用方法。
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