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Background: Previous studies have demonstrated that pooled testing of clinical specimens for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) by nucleic acid amplification results in significant cost-savings without a decrease in accuracy.
Objectives: To determine if pooled testing decreases test costs in the laboratory while maintaining acceptable accuracy, pooled testing of urine and endocervical specimens for CT and GC was validated. Sensitivity, specificity, and cost-savings were evaluated.
Methods: Pooled testing was validated by testing serial dilutions of known positive specimens to determine the number of specimens that could be pooled without compromising the sensitivity of the assay. Accurate results were obtained when up to four specimens were used per testing pool. Positive pools were deconstructed and individual specimens were tested to identify the positive specimen(s). We performed pooled testing on a total of 5,884 specimens from November 1, 2007 thru May 14, 2008.
Results: A total of 1,471 pools were tested (5,884 specimens) with a pool positivity rate of 24.4%. Deconstruction of positive pools resulted in retesting of 1,436 specimens. With pooling and deconstruction a total of 3,023 reactions were run, resulting in a 50% decrease in the number of reactions that would have been run if the specimens were each tested individually. We calculated a savings of $41,816 over the testing period.
Conclusions: Pooled testing of urine and endocervical specimens for the presence of CT and GC produced acceptable accuracy and significant cost savings. We are in the process of validating pooled testing of vaginal specimens. The pooled approach is cost-effective and provides the Colorado PHL with significant cost-savings.
Implications for Programs, Policy, and/or Research:The cost-savings resulting from pooled testing of specimens for CT and GC will allow for screening of more individuals using the funding currently available for testing.