key: cord-0922474-cluq47xz
authors: Mathew, Susy; Saunders, John; Petty, Jacquelyn; Davis, Rebecca
title: Verification and implementation of a rapid antigen test for SARS-CoV2 detection in clinical settings in Sydney local health district (SLHD)
date: 2022-03-31
journal: Pathology
DOI: 10.1016/j.pathol.2021.12.278
sha: 21dd383c16066a14dcafde04e581af10613c9ddd
doc_id: 922474
cord_uid: cluq47xz

nan

Background: Rapid antigen detection tests (RADTs) offer an alternate diagnostic testing modality for SARS-CoV2. Methodology: A prospective verification study was conducted in SLHD, to assess the diagnostic performance of the Panbio TM COVID-19 RADT compared to conventional NAAT methods. The study was conducted on 81 patients. Results: The overall sensitivity and specificity for the RADT was 65.2% (95% CI 42.7-83.6%) and 100% (95% CI 93.8-100%) respectively. The sensitivity increased to 100% (95% CI 63.06-100%) at high viral loads (Ct 25) which are seen in the earlier stages of infection (within 7 days of onset). Current published literature supports the use of RADT for the detection of early infection. 1, 2 Discussion: Currently, we prefer RADTs for regular (at least twice weekly) surveillance testing in predetermined asymptomatic patients. Serial testing multiple times a week increases the sensitivity of antigen tests. 3 In the current low prevalence setting for COVID-19, secondary testing by nucleic acid amplification test for positive RADT results is done to detect false positive results. Based on our study we have implemented the Panbio TM RADT for SARS-CoV2 testing at POC in predetermined testing populations with advantages of improved turnaround times and early detection of infectious cases. Vibrio parahaemolyticus is a cause of foodborne diarrhoea commonly associated with ingestion of seafood. Many laboratories use multiplex PCR assays to screen for bacterial faecal pathogens, which are narrow spectrum and miss uncommon pathogens. Our laboratory continues to perform culture, which has the advantage that strain typing and susceptibilities can be performed if needed. In 2021, we identified 33 cases as part of at least two outbreaks of V. parahaemolyticus by bacterial culture in our laboratory. Isolates were referred for genetic analysis and outbreak investigation. As a result, two separate clusters were identified; the first occurring in Feb-May and the second from Sept-Nov. Within the first cluster of 14 cases, 11 were highly related on genomic sequencing, suggesting acquisition from a common source. The second cluster included 67 cases, of which MLST was available for 49. Two MLST were identified that suggested this outbreak is distinct from the earlier cluster. As a precautionary measure, oyster production areas of Coffin Bay were closed. These V. parahaemolyticus cases were identified through the routine bacterial culture of faecal specimens, and notification was initiated by our laboratory given the high index of suspicion for an outbreak. We recommend that this organism be notifiable in Victoria. 

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