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Bernstein DI, Mejias A, Rath B, Woods CW, Deeter JP. Summarizing Study Characteristics and Diagnostic Performance of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era. J Appl Lab Med 2023; 8:353-371. [PMID: 35854475 PMCID: PMC9384538 DOI: 10.1093/jalm/jfac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 06/07/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Nonpharmaceutical interventions to prevent the spread of coronavirus disease 2019 also decreased the spread of respiratory syncytial virus (RSV) and influenza. Viral diagnostic testing in patients with respiratory tract infections (RTI) is a necessary tool for patient management; therefore, sensitive and specific tests are required. This scoping literature review aimed to summarize the study characteristics of commercially available sample-to-answer RSV tests. CONTENT PubMed and Embase were queried for studies reporting on the diagnostic performance of tests for RSV in patients with RTI (published January 2005-January 2021). Information on study design, patient and setting characteristics, and published diagnostic performance of RSV tests were extracted from 77 studies that met predefined inclusion criteria. A literature gap was identified for studies of RSV tests conducted in adult-only populations (5.3% of total subrecords) and in outpatient (7.5%) or household (0.8%) settings. Overall, RSV tests with analytical time >30 min had higher published sensitivity (62.5%-100%) vs RSV tests with analytical time ≤30 min (25.7%-100%); this sensitivity range could be partially attributed to the different modalities (antigen vs molecular) used. Molecular-based rapid RSV tests had higher published sensitivity (66.7%-100%) and specificity (94.3%-100%) than antigen-based RSV tests (sensitivity: 25.7%-100%; specificity:80.3%-100%). SUMMARY This scoping review reveals a paucity of literature on studies of RSV tests in specific populations and settings, highlighting the need for further assessments. Considering the implications of these results in the current pandemic landscape, the authors preliminarily suggest adopting molecular-based RSV tests for first-line use in these settings.
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Affiliation(s)
- David I Bernstein
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Asuncion Mejias
- Department of Pediatrics, Division of Infectious Diseases, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, USA
- Center for Vaccines and Immunity, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA
| | - Barbara Rath
- Vienna Vaccine Safety Initiative, Berlin, Germany
- Université de Bourgogne Franche-Comté, Besançon, France
- ESCMID Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland
| | - Christopher W Woods
- ESCMID Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland
- Infectious Diseases Division, Duke University Medical Center, Durham, NC, USA
| | - Jamie Phillips Deeter
- ESCMID Study Group for Respiratory Viruses (ESGREV), Basel, Switzerland
- Roche Diagnostics Corporation, Indianapolis, IN, USA
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Hou N, Wang K, Zhang H, Bai M, Chen H, Song W, Jia F, Zhang Y, Han S, Xie B. Comparison of detection rate of 16 sampling methods for respiratory viruses: a Bayesian network meta-analysis of clinical data and systematic review. BMJ Glob Health 2020; 5:bmjgh-2020-003053. [PMID: 33168521 PMCID: PMC7654123 DOI: 10.1136/bmjgh-2020-003053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/18/2020] [Accepted: 10/14/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Respiratory viruses (RVs) is a common cause of illness in people of all ages, at present, different types of sampling methods are available for respiratory viral diagnosis. However, the diversity of available sampling methods and the limited direct comparisons in randomised controlled trials (RCTs) make decision-making difficult. We did a network meta-analysis, which accounted for both direct and indirect comparisons, to determine the detection rate of different sampling methods for RVs. METHODS Relevant articles were retrieved comprehensively by searching the online databases of PubMed, Embase and Cochrane published before 25 March 2020. With the help of R V.3.6.3 software and 'GeMTC V.0.8.2' package, network meta-analysis was performed within a Bayesian framework. Node-splitting method and I 2 test combined leverage graphs and Gelman-Rubin-Brooks plots were conducted to evaluate the model's accuracy. The rank probabilities in direct and cumulative rank plots were also incorporated to rank the corresponding sampling methods for overall and specific virus. RESULTS 16 sampling methods with 54 438 samples from 57 literatures were ultimately involved in this study. The model indicated good consistency and convergence but high heterogeneity, hence, random-effect analysis was applied. The top three sampling methods for RVs were nasopharyngeal wash (NPW), mid-turbinate swab (MTS) and nasopharyngeal swab (NPS). Despite certain differences, the results of virus-specific subanalysis were basically consistent with RVs: MTS, NPW and NPS for influenza; MTS, NPS and NPW for influenza-a and b; saliva, NPW and NPS for rhinovirus and parainfluenza; NPW, MTS and nasopharyngeal aspirate for respiratory syncytial virus; saliva, NPW and MTS for adenovirus and sputum; MTS and NPS for coronavirus. CONCLUSION This network meta-analysis provides supporting evidences that NPW, MTS and NPS have higher diagnostic value regarding RVs infection, moreover, particular preferred methods should be considered in terms of specific virus pandemic. Of course, subsequent RCTs with larger samples are required to validate our findings.
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Affiliation(s)
- Nianzong Hou
- Department of Hand and Foot Surgery, Zibo Central Hospital,Shandong First Medical University, Zibo, Shandong, China
| | - Kai Wang
- Department of Critical Care Medicine, Zibo central hospital, Zibo, Shandong, China
| | - Haiyang Zhang
- Department of Hand and Foot Surgery, Zibo Central Hospital,Shandong First Medical University, Zibo, Shandong, China
| | - Mingjian Bai
- Department of Clinical Laboratory, Aerospace Central Hospital, Beijing, China
| | - Hao Chen
- Department of spine Surgery, Renji Hospital, Shanghai, China
| | - Weidong Song
- Department of Orthopedic Surgery, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China
| | - Fusen Jia
- Department of Hand and Foot Surgery, Zibo Central Hospital,Shandong First Medical University, Zibo, Shandong, China
| | - Yi Zhang
- Department of Hand and Foot Surgery, Zibo Central Hospital,Shandong First Medical University, Zibo, Shandong, China
| | - Shiliang Han
- Department of Hand and Foot Surgery, Zibo Central Hospital,Shandong First Medical University, Zibo, Shandong, China
| | - Bing Xie
- Department of Hand and Foot Surgery, Zibo Central Hospital,Shandong First Medical University, Zibo, Shandong, China
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Cantais A, Mory O, Plat A, Giraud A, Pozzetto B, Pillet S. Analytical performances of the BD Veritor™ System for the detection of respiratory syncytial virus and influenzaviruses A and B when used at bedside in the pediatric emergency department. J Virol Methods 2019; 270:66-69. [PMID: 31047969 DOI: 10.1016/j.jviromet.2019.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/25/2019] [Accepted: 04/26/2019] [Indexed: 11/18/2022]
Abstract
This study aims to evaluate the analytical performance of the BD Veritor™ rapid diagnostic assays (RDTs) for respiratory syncytial virus (RSV) and influenzaviruses when performed 24/7 at bedside by nurses in the pediatric emergency department (PED). The study was performed between 14/10/2015 and 19/03/2016 on nasopharyngeal aspirates (NPAs) collected from children consulting at the PED of the University Hospital of Saint-Etienne for bronchiolitis (RSV detection) or flu-like syndrome (influenzaviruses A/B detection). NPAs were tested 24/7 at the PED with the RDT and then sent to the Infectious Agents Department for routine analyses, first by immunofluorescence assay (IFA), then by nucleic acid amplification test (NAAT) considered as the gold standard in case of discrepancy between RDT and IFA results. For RSV detection, 205 NPAs was analyzed; the overall concordance between RDT and routine assays was of 97.6% (200/205). The sensitivity (Se), specificity (Sp), negative predictive value (NPV) and positive predictive value (PPV) were of 97.6% (160/164), 97.6% (40/41), 90.9% (40/44) and 99.4% (160/161), respectively. A total of 419 NPA was tested for influenzaviruses. For influenzavirus A, the overall concordance was of 98.8% (414/419); Se, Sp, NPV and PPV were of 100% (41/41), 98.7% (373/378), 100% (373/373) and 89.1% (41/46), respectively. For influenzavirus B, the overall concordance was of 97.9% (410/419); Se, Sp, NPV and PPV were of 96.6% (172/178), 98.8% (238/241), 97.5% (238/244) and 98.3% (172/175), respectively. Due to their excellent performances and their easy handle by non-laboratory personnel, these RDTs can be warmly recommended as point of care assays at the PED.
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Affiliation(s)
- Aymeric Cantais
- Pediatric Emergency Department, University Hospital of Saint-Etienne, France; Laboratory Group on Mucosal Immunity and Pathogens (GIMAP EA3064), Faculty of Medicine of Saint-Etienne, University of Lyon, France
| | - Olivier Mory
- Pediatric Emergency Department, University Hospital of Saint-Etienne, France
| | - Aurélie Plat
- Pediatric Emergency Department, University Hospital of Saint-Etienne, France
| | - Antoine Giraud
- Pediatric Emergency Department, University Hospital of Saint-Etienne, France
| | - Bruno Pozzetto
- Laboratory Group on Mucosal Immunity and Pathogens (GIMAP EA3064), Faculty of Medicine of Saint-Etienne, University of Lyon, France; Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Sylvie Pillet
- Laboratory Group on Mucosal Immunity and Pathogens (GIMAP EA3064), Faculty of Medicine of Saint-Etienne, University of Lyon, France; Laboratory of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, Saint-Etienne, France.
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4
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Takayama I, Nakauchi M, Takahashi H, Oba K, Semba S, Kaida A, Kubo H, Saito S, Nagata S, Odagiri T, Kageyama T. Development of real-time fluorescent reverse transcription loop-mediated isothermal amplification assay with quenching primer for influenza virus and respiratory syncytial virus. J Virol Methods 2019; 267:53-58. [PMID: 30831121 PMCID: PMC7113748 DOI: 10.1016/j.jviromet.2019.02.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/31/2019] [Accepted: 02/28/2019] [Indexed: 12/20/2022]
Abstract
Influenza virus and respiratory syncytial virus cause acute upper and lower respiratory tract infections, especially in children and the elderly. Early treatment for these infections is thought to be important, so simple and sensitive detection methods are needed for use at clinical sites. Therefore, in this study, real-time reverse transcription loop-mediated isothermal amplification assays with quenching primer for influenza virus and respiratory syncytial virus were developed. Evaluation of a total of 113 clinical specimens compared to real-time RT-PCR assays showed that the novel assays could distinguish between the types and subtypes of influenza virus and respiratory syncytial virus and had 100% diagnostic specificity. The diagnostic sensitivity of each assay exceeded 85.0% and the assays showed sufficient clinical accuracy. Furthermore, positive results could be obtained in around 15 min using the novel assays in cases with high concentrations of virus. The developed assays should be useful for identifying influenza virus and respiratory syncytial virus cases not only in experimental laboratories but also in hospital and quarantine laboratories.
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Affiliation(s)
- Ikuyo Takayama
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Mina Nakauchi
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Hitoshi Takahashi
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Kunihiro Oba
- Department of Pediatrics, Showa General Hospital, 8-1-1 Hanakoganei, Kodaira-shi, Tokyo 187-0002, Japan
| | - Shohei Semba
- Eiken Chemical Co. Ltd., 4-19-9 Taito, Taito-ku, Tokyo 110-8408, Japan
| | - Atsushi Kaida
- Division of Microbiology, Osaka Institute of Public Health, 8-34 Tojo-cho, Tennoji-ku, Osaka 543-0026, Japan
| | - Hideyuki Kubo
- Division of Microbiology, Osaka Institute of Public Health, 8-34 Tojo-cho, Tennoji-ku, Osaka 543-0026, Japan
| | - Shinji Saito
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Shiho Nagata
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Takato Odagiri
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan
| | - Tsutomu Kageyama
- Influenza Virus Research Center, National Institute of Infectious Diseases, 4-7-1 Gakuen, Musashimurayama-shi, Tokyo 208-0011, Japan.
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Tang JW, Blount J, Bradley C, Donaghy B, Shardlow C, Bandi S, Baxter C, Hunter A, Range S, Lam TT. Impact of a poorly performing point-of-care test during the 2017-2018 influenza season. J Infect 2018; 78:249-259. [PMID: 30408493 PMCID: PMC7172292 DOI: 10.1016/j.jinf.2018.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 10/13/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Julian W Tang
- Clinical Microbiology and Virology, University Hospitals of Leicester NHS Trust, Level 5 Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK; Infection, Immunity, Inflammation, University of Leicester, Leicester, UK.
| | - Janice Blount
- Infection Prevention and Control, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Carina Bradley
- Clinical Microbiology and Virology, University Hospitals of Leicester NHS Trust, Level 5 Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK
| | - Bernadette Donaghy
- Adult Cystic Fibrosis Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Carol Shardlow
- Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Srini Bandi
- Children's Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Caroline Baxter
- Clinical Decisions Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Ann Hunter
- Haematology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Simon Range
- Adult Cystic Fibrosis Unit, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Tommy Ty Lam
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
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Multicenter Clinical Evaluation of the Alere i Respiratory Syncytial Virus Isothermal Nucleic Acid Amplification Assay. J Clin Microbiol 2018; 56:JCM.01777-17. [PMID: 29263208 DOI: 10.1128/jcm.01777-17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/12/2017] [Indexed: 02/07/2023] Open
Abstract
The Alere i respiratory syncytial virus (RSV) assay is an isothermal nucleic acid amplification test capable of detecting RSV directly from respiratory specimens, with results being available in ≤13 min after test initiation. The objective of this study was to evaluate the performance characteristics of the Alere i RSV assay in a point-of-care setting by using direct nasopharyngeal (NP) swab specimens (direct NP) and nasopharyngeal swab specimens eluted and transported in viral transport medium (VTM NP). The study was a prospective, multicenter, clinical trial conducted at 9 sites across the United States to evaluate the clinical performance of the Alere i RSV assay with respiratory specimens obtained from both children (age, <18 years) and older adults (age, >60 years). The performance of the Alere i RSV assay was compared with that of the reference method, the Prodesse ProFlu+ real-time reverse transcriptase PCR (RT-PCR) assay. All specimens with discrepant test results were tested further by a second FDA-cleared PCR assay (the Verigene respiratory virus plus nucleic acid test; Luminex Inc., TX). A total of 554 subjects with signs and symptoms of respiratory infections were enrolled, and respiratory samples were collected in this study. In comparison with the ProFlu+ real-time RT-PCR, the overall sensitivity and specificity of Alere i RSV assay for the detection of RSV were 98.6% (95% confidence interval [CI], 94.4 to 99.7%) and 98.0% (95% CI, 95.8 to 99.1%), respectively, for direct NP and 98.6% (95% CI, 94.4 to 99.7%) and 97.8% (95% CI, 95.5 to 98.9%), respectively, for VTM NP. The Alere i RSV is a highly sensitive and specific molecular assay ideal for rapid RSV detection in patients in the point-of-care setting due to its minimal hands-on time and rapid result availability.
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Abstract
Introduction: Successful treatment outcomes for viral respiratory tract infections presenting from primary health care to quaternary hospitals will only be achieved with rapid, sensitive and specific identification of pathogens to allow effective pathogen-specific antiviral therapy and infection control measures. Areas covered: This review aims to explore the different point-of-care tests currently available to diagnose viral respiratory tract infections, discuss the advantages and limitations of point-of-care testing, and provide insights into the future of point-of-care tests. The following databases were searched: Medline (January 1996 to 30 September 2017) and Embase (1988 to 30 September 2017), using the following keywords: ‘point of care’, ‘respiratory virus’, ‘influenza’, ‘RSV’, ‘diagnostics’, ‘nucleic acid test’ and ‘PCR’. Expert commentary: Viral respiratory tract infections cause significant morbidity and mortality worldwide, and point-of-care tests are facilitating the rapid identification of the pathogen responsible given the similarities in clinical presentation.
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Affiliation(s)
- Kerri Basile
- a Centre for Infectious Diseases and Microbiology Laboratory Services , Institute of Clinical Pathology and Medical Research, NSW Health Pathology , Westmead , Australia.,b Marie Bashir Institute for Emerging Infections and Biosecurity , University of Sydney, Westmead Hospital , Westmead , Australia
| | - Jen Kok
- a Centre for Infectious Diseases and Microbiology Laboratory Services , Institute of Clinical Pathology and Medical Research, NSW Health Pathology , Westmead , Australia.,b Marie Bashir Institute for Emerging Infections and Biosecurity , University of Sydney, Westmead Hospital , Westmead , Australia
| | - Dominic E Dwyer
- a Centre for Infectious Diseases and Microbiology Laboratory Services , Institute of Clinical Pathology and Medical Research, NSW Health Pathology , Westmead , Australia.,b Marie Bashir Institute for Emerging Infections and Biosecurity , University of Sydney, Westmead Hospital , Westmead , Australia
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Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment. Clin Microbiol Rev 2017; 30:277-319. [PMID: 27903593 DOI: 10.1128/cmr.00010-16] [Citation(s) in RCA: 342] [Impact Index Per Article: 48.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Respiratory syncytial virus (RSV) infection is a significant cause of hospitalization of children in North America and one of the leading causes of death of infants less than 1 year of age worldwide, second only to malaria. Despite its global impact on human health, there are relatively few therapeutic options available to prevent or treat RSV infection. Paradoxically, there is a very large volume of information that is constantly being refined on RSV replication, the mechanisms of RSV-induced pathology, and community transmission. Compounding the burden of acute RSV infections is the exacerbation of preexisting chronic airway diseases and the chronic sequelae of RSV infection. A mechanistic link is even starting to emerge between asthma and those who suffer severe RSV infection early in childhood. In this article, we discuss developments in the understanding of RSV replication, pathogenesis, diagnostics, and therapeutics. We attempt to reconcile the large body of information on RSV and why after many clinical trials there is still no efficacious RSV vaccine and few therapeutics.
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Berry GJ, Oladipo O, Wittnebert D, Loeffelholz MJ, Petersen JR. Comparison of the Alere i and BD Veritor Assays for the Rapid Detection of Influenza A and B Viruses. J Appl Lab Med 2017; 1:735-739. [PMID: 33379826 DOI: 10.1373/jalm.2016.022350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/10/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND The use of point-of care testing (POCT) in patient management decisions is becoming increasingly common. Our goal was to evaluate the diagnostic performance of 2 commercially available rapid POCT devices for influenza viruses A and B: the Alere™ i Instrument (Alere, Scarborough) and the BD Veritor™ System (BD Diagnostics). METHODS Paired nasopharyngeal swabs were collected from patients (18-71 years) presenting with influenza-like symptoms at 3 outpatient clinics. A total of 65 samples were obtained. The Alere i and BD Veritor were performed according to the manufacturers' instructions. Discordant results were resolved using real-time reverse transcription PCR (RT-PCR). RESULTS In a head-to-head comparison involving symptomatic adult patients visiting outpatient clinics during the 2014-2015 and 2015-2016 influenza seasons, the Alere i and BD Veritor had 90.63% agreement in the detection of influenza A virus and a statistically significant observed κ coefficient of 0.754 (P <0.0001). Discordant results between the Alere i and BD Veritor were further investigated using RT-PCR, showing that the BD Veritor missed 5 positive influenza A virus results (false negatives) and detected 1 false positive, while the Alere i results agreed with all RT-PCR results. There were no discordant results between the Alere i and BD Veritor in the detection of influenza B virus. CONCLUSIONS Our data suggest that the Alere i has higher sensitivity and specificity than the BD Veritor in the detection of influenza A virus. Both assays showed equal performance in the detection of influenza B virus.
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Affiliation(s)
- Gregory J Berry
- Department of Pathology, University of Texas Medical Branch, Galveston, TX.,Current affiliation: Northwell Health, Department of Pathology and Laboratory Medicine, Lake Success, NY
| | - Olajumoke Oladipo
- Department of Pathology, University of Texas Medical Branch, Galveston, TX
| | | | | | - John R Petersen
- Department of Pathology, University of Texas Medical Branch, Galveston, TX
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Jung BK, Choi SH, Lee JH, Lee J, Lim CS. Performance evaluation of four rapid antigen tests for the detection of Respiratory syncytial virus. J Med Virol 2016; 88:1720-4. [PMID: 26990654 DOI: 10.1002/jmv.24522] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2016] [Indexed: 11/10/2022]
Abstract
Rapid identification of Respiratory syncytial virus (RSV) is important in the management of infected patients. Rapid diagnostic tests (RDT) are widely used for this purpose. This study aimed to evaluate the clinical performance of four RSV antigen tests including the BinaxNow RSV Card test, SD Bioline RSV test, BD Veritor RSV test, and Humasis RSV antigen test in comparison with real-time RT-PCR as the reference method. Nasopharyngeal swabs were collected from 280 patients with symptoms of lower respiratory tract infection and stored at -80°C. All swabs were tested for RSV using four rapid antigen tests and real time RT-PCR. The sensitivity of the BinaxNow RSV Card test, SD Bioline RSV test, BD Veritor RSV test, and Humasis RSV Antigen tests were 62.5%, 61.3%, 65.0%, and 67.5% for RSV A, and 61.3%, 65.0%, 61.3%, and 67.5% for RSV B compared to real time RT-PCR, respectively. The specificity of BD Veritor RSV test was 95.8% and those of the other three RDTs was 100%. Commercial RSV antigen detection assays are useful tools for the rapid diagnosis of RSV infection. However, confirmatory testing is always recommended. J. Med. Virol. 88:1720-1724, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Bo Kyeung Jung
- Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Sung Hyuk Choi
- Department of Emergency Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - Jong Han Lee
- Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, South Korea
| | - JungHwa Lee
- Department of Pediatrics, College of Medicine, Korea University, Seoul, South Korea
| | - Chae Seung Lim
- Department of Laboratory Medicine, College of Medicine, Korea University, Seoul, South Korea
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Diagnostic Accuracy of Rapid Antigen Detection Tests for Respiratory Syncytial Virus Infection: Systematic Review and Meta-analysis. J Clin Microbiol 2015; 53:3738-49. [PMID: 26354816 DOI: 10.1128/jcm.01816-15] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/01/2015] [Indexed: 11/20/2022] Open
Abstract
Respiratory syncytial virus (RSV) rapid antigen detection tests (RADT) are extensively used in clinical laboratories. We performed a systematic review and meta-analysis to evaluate the accuracy of RADTs for diagnosis of RSV infection and to determine factors associated with accuracy estimates. We searched EMBASE and PubMed for diagnostic-accuracy studies of commercialized RSV RADTs. Studies reporting sensitivity and specificity data compared to a reference standard (reverse transcriptase PCR [RT-PCR], immunofluorescence, or viral culture) were considered. Two reviewers independently extracted data on study characteristics, diagnostic-accuracy estimates, and study quality. Accuracy estimates were pooled using bivariate random-effects regression models. Heterogeneity was investigated with prespecified subgroup analyses. Seventy-one articles met inclusion criteria. Overall, RSV RADT pooled sensitivity and specificity were 80% (95% confidence interval [CI], 76% to 83%) and 97% (95% CI, 96% to 98%), respectively. Positive- and negative-likelihood ratios were 25.5 (95% CI, 18.3 to 35.5) and 0.21 (95% CI, 0.18 to 0.24), respectively. Sensitivity was higher in children (81% [95% CI, 78%, 84%]) than in adults (29% [95% CI, 11% to 48%]). Because of this disparity, further subgroup analyses were restricted to pediatric data (63 studies). Test sensitivity was poorest using RT-PCR as a reference standard and highest using immunofluorescence (74% versus 88%; P < 0.001). Industry-sponsored studies reported significantly higher sensitivity (87% versus 78%; P = 0.01). Our results suggest that the poor sensitivity of RSV RADTs in adults may preclude their use in this population. Furthermore, industry-sponsored studies and those that did not use RT-PCR as a reference standard likely overestimated test sensitivity.
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Jonckheere S, Verfaillie C, Boel A, Van Vaerenbergh K, Vanlaere E, Vankeerberghen A, De Beenhouwer H. Multicenter evaluation of BD Veritor System and RSV K-SeT for rapid detection of respiratory syncytial virus in a diagnostic laboratory setting. Diagn Microbiol Infect Dis 2015; 83:37-40. [PMID: 26092509 DOI: 10.1016/j.diagmicrobio.2015.05.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 04/22/2015] [Accepted: 05/18/2015] [Indexed: 11/17/2022]
Abstract
The recently introduced BD Veritor System RSV laboratory kit (Becton Dickinson, Sparks, MD, USA) with automatic reading was evaluated and compared with the RSV K-SeT (Coris BioConcept, Gembloux, Belgium) for the detection of respiratory syncytial virus (RSV) using 248 nasopharyngeal aspirates of children younger than 6 years old with respiratory tract infection. Compared to reverse transcriptase polymerase chain reaction as gold standard, both tests had an identical sensitivity of 78.1% and a specificity of 96.8% and 95.8% for the BD Veritor System and RSV K-SeT, respectively. Both antigen tests can be used to reliably confirm RSV in young children. However, a negative result does not definitively exclude the presence of RSV.
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Affiliation(s)
- Stijn Jonckheere
- Clinical Laboratory of Microbiology, OLVZ Aalst, Moorselbaan 164, 9300 Aalst, Belgium
| | - Charlotte Verfaillie
- Clinical Laboratory of Microbiology, AZ Sint-Lucas Gent, Groenebriel 1, 9000 Gent, Belgium
| | - An Boel
- Clinical Laboratory of Microbiology, OLVZ Aalst, Moorselbaan 164, 9300 Aalst, Belgium
| | | | - Elke Vanlaere
- Clinical Laboratory of Microbiology, AZ Sint-Lucas Gent, Groenebriel 1, 9000 Gent, Belgium
| | - Anne Vankeerberghen
- Clinical Laboratory of Microbiology, OLVZ Aalst, Moorselbaan 164, 9300 Aalst, Belgium
| | - Hans De Beenhouwer
- Clinical Laboratory of Microbiology, OLVZ Aalst, Moorselbaan 164, 9300 Aalst, Belgium.
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Kanwar N, Hassan F, Nguyen A, Selvarangan R. Head-to-head comparison of the diagnostic accuracies of BD Veritor™ System RSV and Quidel® Sofia® RSV FIA systems for respiratory syncytial virus (RSV) diagnosis. J Clin Virol 2015; 65:83-6. [PMID: 25766995 DOI: 10.1016/j.jcv.2015.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/06/2015] [Accepted: 02/09/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is one of the most common causes of severe lower respiratory tract disease among infants and young children. BD Veritor™ System RSV (BD) and Quidel(®) Sofia(®) RSV FIA (QD) are the new generation lateral flow digital immunoassay (DIA) tests with an instrumented read for the qualitative detection of RSV viral antigens. OBJECTIVE To compare the diagnostic accuracies of BD and QD for RSV detection using fresh nasopharyngeal aspirates and nasopharyngeal swab specimens collected in universal transport media during 2013-2014 respiratory season. STUDY DESIGN The two DIA tests were performed simultaneously on randomly selected specimens on a weekly basis during the RSV season until 200 fresh remnant specimens were enrolled. Real-time RT-PCR assay results were used to compare and evaluate the performance of both RSV DIA assays. RESULTS Among 200 specimens tested, RSV real-time RT-PCR assay detected RSV in 104 samples, while QD detected 84 samples and BD detected 74 samples as positive. The overall sensitivity for detection of RSV in comparison to PCR was 71.15% (61.3-79.4) for BD and 80.77% (71.6-87.6) for QD system (P=0.36). The specificity was 100% (95.2-100) for both systems. The work flow analysis revealed that the overall specimen processing time was significantly lower for BD as compared with the QD assay. CONCLUSIONS In comparison with the real-time PCR, the QD system showed a higher sensitivity than that of the BD system, but the difference did not reach statistical significance (P=0.36). Both BD and QD systems were found comparable in terms of specificity.
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Affiliation(s)
- Neena Kanwar
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA
| | - Ferdaus Hassan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA; University of Missouri, School of Medicine, Kansas City, MO 64108, USA
| | - Ashley Nguyen
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA
| | - Rangaraj Selvarangan
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital and Clinics, Kansas City, MO 64108, USA; University of Missouri, School of Medicine, Kansas City, MO 64108, USA.
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