RESUMO
Background: Regular repeat surveillance testing is a strategy to identify asymptomatic individuals with SARS-CoV-2 infections in high-risk work settings to prevent onward community transmission. Saliva sampling is less invasive compared to nasal/oropharyngeal sampling, thus making it suitable for regular testing. In this multi-centre evaluation, we aimed to validate RT-PCR using salivary swab testing of SARS-CoV-2 for large-scale surveillance testing and assess implementation amongst staff working in the hotel quarantine system in Victoria, Australia. Methods: A multi-centre laboratory evaluation study was conducted to systematically validate the in vitro and clinical performance of salivary swab RT-PCR for implementation of SARS-CoV-2 surveillance testing. Analytical sensitivity for multiple RT-PCR platforms was assessed using a dilution series of known SARS-CoV-2 viral loads, and assay specificity was examined using a panel of viral pathogens other than SARS-CoV-2. In addition, we tested capacity for large-scale saliva testing using a four-sample pooling approach, where positive pools were subsequently decoupled and retested. Regular, frequent self-collected saliva swab RT-PCR testing was implemented for staff across fourteen quarantine hotels. Samples were tested at three diagnostic laboratories validated in this study, and results were provided back to staff in real-time. Findings: The agreement of self-collected saliva swabs for RT-PCR was 84.5% (95% CI 68.6 to 93.8) compared to RT-PCR using nasal/oropharyngeal swab samples collected by a healthcare practitioner, when saliva samples were collected within seven days of symptom onset. Between 7th December 2020 and 17th December 2021, almost 500,000 RT-PCR tests were performed on saliva swabs self-collected by 102 staff working in quarantine hotels in Melbourne. Of these, 20 positive saliva swabs were produced by 13 staff (0.004%). The majority of staff that tested positive occurred during periods of community transmission of the SARS-CoV-2 Delta variant. Interpretation: Salivary RT-PCR had an acceptable level of agreement compared to standard nasal/oropharyngeal swab RT-PCR within early symptom onset. The scalability, tolerability and ease of self-collection highlights utility for frequent or repeated testing in high-risk settings, such as quarantine or healthcare environments where regular monitoring of staff is critical for public health, and protection of vulnerable populations. Funding: This work was funded by the Victorian Department of Health.
RESUMO
In Australian export-registered abattoirs microbiological monitoring is carried out within the E. coli and Salmonella Monitoring (ESAM) program. During the calendar year 2003, the ESAM database indicated a national prevalence of Escherichia coli of around 3.0% for steers/heifers and 7.1% for cows/bulls. An investigation was carried out to attempt to elucidate why some establishments had E. coli prevalence markedly higher or markedly lower than the national average. The investigation was based on a questionnaire completed by fifteen export establishments which provided data on livestock, processing, operator training and management. The responses were verified by site visits and then evaluated for their relationship with ESAM data on E. coli in two stages. In stage 1, E. coli prevalence for each abattoir was plotted against each variable recorded by the questionnaire; no single variable was a reasonable predictor for prevalence of E. coli on carcases. In stage 2, variables influencing contamination were grouped under two categories: contamination on incoming livestock (Problem variables) together with the ability of the plant's process to deal with such contamination (Process variables). The analysis prompted two main conclusions. Firstly, plants with a large incoming problem with livestock (long haul, high tag score and proportion of cows/bulls slaughtered) plus "poor" processes had higher than average E. coli prevalence. Secondly, plants with hot water decontamination systems had low E. coli prevalence even when there was a substantial incoming problem with livestock, such as a relatively high proportion of cows/bulls.
