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. 2023 Mar;28(9):2200618.
doi: 10.2807/1560-7917.ES.2023.28.9.2200618.

Sequencing directly from antigen-detection rapid diagnostic tests in Belgium, 2022: a gamechanger in genomic surveillance?

Annabel Rector  1 , Mandy Bloemen  1 , Gilberte Schiettekatte  2 , Piet Maes  1 , Marc Van Ranst  1   3 , Elke Wollants  1
Affiliations

Sequencing directly from antigen-detection rapid diagnostic tests in Belgium, 2022: a gamechanger in genomic surveillance?

Annabel Rector et al. Euro Surveill. 2023 Mar.

Abstract

BackgroundLateral flow antigen-detection rapid diagnostic tests (Ag-RDTs) for viral infections constitute a fast, cheap and reliable alternative to nucleic acid amplification tests (NAATs). Whereas leftover material from NAATs can be employed for genomic analysis of positive samples, there is a paucity of information on whether viral genetic characterisation can be achieved from archived Ag-RDTs.AimTo evaluate the possibility of retrieving leftover material of several viruses from a range of Ag-RDTs, for molecular genetic analysis.MethodsArchived Ag-RDTs which had been stored for up to 3 months at room temperature were used to extract viral nucleic acids for subsequent RT-qPCR, Sanger sequencing and Nanopore whole genome sequencing. The effects of brands of Ag-RDT and of various ways to prepare Ag-RDT material were evaluated.ResultsSARS-CoV-2 nucleic acids were successfully extracted and sequenced from nine different brands of Ag-RDTs for SARS-CoV-2, and for five of these, after storage for 3 months at room temperature. The approach also worked for Ag-RDTs for influenza virus (n = 3 brands), as well as for rotavirus and adenovirus 40/41 (n = 1 brand). The buffer of the Ag-RDT had an important influence on viral RNA yield from the test strip and the efficiency of subsequent sequencing.ConclusionOur finding that the test strip in Ag-RDTs is suited to preserve viral genomic material, even for several months at room temperature, and therefore can serve as source material for genetic characterisation could help improve global coverage of genomic surveillance for SARS-CoV-2 as well as for other viruses.

Keywords: Nanopore whole genome sequencing; Rapid antigen test (Ag RDT); SARS-CoV-2; Sanger sequencing; adenovirus; genomic surveillance; influenza virus; rotavirus.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure
Figure
Example of an opened cassette of a lateral flow antigen-detection rapid diagnostic test for influenza and COVID-19a, Belgium, 2022
See this image and copyright information in PMC

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