RESUMO
OBJECTIVES: The standard RT-PCR assay for coronavirus disease 2019 (COVID-19) is laborious and time-consuming, limiting testing availability. Rapid antigen-detection tests are faster and less expensive; however, the reliability of these tests must be validated before they can be used widely. The objective of this study was to determine the performance of the Panbio™ COVID-19 Ag Rapid Test Device (PanbioRT) (Abbott) in detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swab specimens. METHODS: This prospective multicentre study was carried out in ten Spanish university hospitals and included individuals with clinical symptoms or epidemiological criteria of COVID-19. Only individuals with ≤7 days from the onset of symptoms or from exposure to a confirmed case of COVID-19 were included. Two nasopharyngeal samples were taken to perform the PanbioRT as a point-of-care test and a diagnostic RT-PCR test. RESULTS: Among the 958 patients studied, 325 (90.5%) had true-positive results. The overall sensitivity and specificity for the PanbioRT were 90.5% (95%CI 87.5-93.6) and 98.8% (95%CI 98-99.7), respectively. Sensitivity in participants who had a threshold cycle (CT) < 25 for the RT-PCR test was 99.5% (95%CI 98.4-100), and in participants with ≤5 days of the clinical course it was 91.8% (95%CI 88.8-94.8). Agreement between techniques was 95.7% (κ score 0.90; 95%CI 0.88-0.93). CONCLUSIONS: The PanbioRT performs well clinically, with even more reliable results for patients with a shorter clinical course of the disease or a higher viral load. The results must be interpreted based on the local epidemiological context.
RESUMO
Background. Between July 2009 and September 2010, an outbreak of multidrug-resistant (MDR) Acinetobacter baumannii was detected in one critical care unit of a tertiary hospital in the Basque Country, involving 49 infected and 16 colonized patients. The aim was to evaluate the impact of environmental cleaning and systematic sampling from environmental objects on the risk of infection by MDR A. baumannii. Methods. After systematic sampling from environmental objects and molecular typing of all new MDR A. baumannii strains from patients and environmental isolates, we analyzed the correlation (Pearson's r) between new infected cases and positive environmental samples. The risk ratio (RR) of infection was estimated with Poisson regression. Results. The risk increased significantly with the number of positive samples in common areas (RR = 1.40; 95%CI = 0.99-1.94) and positive samples in boxes (RR = 1.19; 95%CI = 1.01-1.40). The number of cases also positively correlated with positive samples in boxes (r = 0.50; P < 0.05) and common areas (r = 0.29; P = 0.18). Conclusion. Once conventional measures have failed, environmental cleaning, guided by systematic sampling from environmental objects, provided the objective risk reduction of new cases and enabled the full control of the outbreak.