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Blair RH, Dawson ED, Taylor AW, Johnson JE, Slinskey AH, O'Neil K, Smolak AW, Toth E, Liikanen K, Stoughton RS, Smith CB, Talbot S, Rowlen KL. Clinical validation of the FluChip-8G Influenza A+B Assay for influenza type and subtype identification. J Clin Virol 2019; 118:20-27. [PMID: 31382226 PMCID: PMC6717662 DOI: 10.1016/j.jcv.2019.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/17/2019] [Accepted: 07/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The FluChip-8G Influenza A+B Assay is a multiplexed influenza RT-PCR and microarray-based assay with same day turnaround time, developed to subtype seasonal A viruses (H1N1pdm2009 and H3N2), distinguish B viruses as Yamagata or Victoria lineage, and is the only FDA cleared assay capable of positive identification of a wide variety of A subtypes as "non-seasonal" A viruses from human nasal specimens. OBJECTIVE To evaluate clinical performance of the FluChip-8G Influenza A+B Assay for detection of seasonal influenza viruses in nasal and nasopharyngeal swab specimens, and to evaluate performance for detection of non-seasonal influenza viruses using contrived samples. STUDY DESIGN For seasonal viruses, a multisite study of the FluChip-8G Influenza A+B Assay using prospectively and retrospectively collected nasal and nasopharyngeal swabs was performed using the FDA-cleared CDC Human Flu Dx Panel as the comparator assay. For non-seasonal viruses, testing was performed at a single site using contrived samples from 100 unique non-seasonal strains representing 41 subtypes. RESULTS Sensitivity (95% CI) and specificity (95% CI) for each target group, respectively, from results of 1689 clinical specimens were: seasonal H1N1pdm2009: 96.4% (87.9-99.0), 99.3% (98.8-99.6), seasonal H3N2: 91.8% (87.7-94.7), 99.7% (99.2-99.9), Influenza B Victoria: 100% (94.0-100.0), 99.9% (99.6-100.0), and Influenza B Yamagata: 95.6% (89.2-98.3), 99.9% (99.6-100.0). The sensitivity and specificity from contrived influenza A non-seasonal viruses was determined to be 99.0% (94.6-99.8) and 100% (96.7-100.0). CONCLUSION The FluChip-8G Influenza A+B Assay has robust sensitivity and specificity for detecting and identifying all target virus groups, including non-seasonal influenza A, with same day results.
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Affiliation(s)
- Rebecca H Blair
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - Erica D Dawson
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA.
| | - Amber W Taylor
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - James E Johnson
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - Amelia H Slinskey
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - Kelly O'Neil
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - Andrew W Smolak
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - Evan Toth
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | - Kyle Liikanen
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
| | | | - Catherine B Smith
- Influenza Division, the Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Sarah Talbot
- Influenza Division, the Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30333, USA
| | - Kathy L Rowlen
- InDevR, Inc. 2100 Central Avenue, Suite 106, Boulder, CO, 80301, USA
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Abstract
Acute upper and lower respiratory infections are a major public health problem and a leading cause of morbidity and mortality worldwide. At greatest risk are young children, the elderly, the chronically ill, and those with suppressed or compromised immune systems. Viruses are the predominant cause of respiratory tract illnesses and include RNA viruses such as respiratory syncytial virus, influenza virus, parainfluenza virus, metapneumovirus, rhinovirus, and coronavirus. Laboratory testing is required for a reliable diagnosis of viral respiratory infections, as a clinical diagnosis can be difficult since signs and symptoms are often overlapping and not specific for any one virus. Recent advances in technology have resulted in the development of newer diagnostic assays that offer great promise for rapid and accurate detection of respiratory viral infections. This chapter emphasizes the fundamental characteristics and clinical importance of the various RNA viruses that cause upper and lower respiratory tract diseases in the immunocompromised host. It highlights the laboratory methods that can be used to make a rapid and definitive diagnosis for the greatest impact on the care and management of ill patients, and the prevention and control of hospital-acquired infections and community outbreaks.
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Zelyas N, Shokoples S, Droogers J, Lundeberg R, Leedell D, Drews SJ. Performance of the Alere™ i Influenza A&B and the Cepheid Xpert® Flu/RSV XC assays. Future Virol 2017. [DOI: 10.2217/fvl-2017-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Aim: To evaluate the Alere™ i Influenza A&B assay and the Xpert® Flu/RSV XC assay using nasopharyngeal aspirates and swabs not provided in the commercial kits. Methods: Specimens were tested with the Alere i Influenza A&B and the Xpert Flu/RSV XC assays and compared with reference methods. Results: Compared with the comparator methods and following discordant analysis, the sensitivity of the i Influenza A&B assay was 63.3% for influenza A and 83.3% for influenza B. For the Xpert Flu/RSV XC assay, sensitivity was 100% for influenza A and B and respiratory syncytial virus. The specificity for all test systems was 100%. Conclusion: The Xpert Flu/RSV XC assay out-performed the Alere i Influenza A&B assay in all diagnostic characteristics evaluated.
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Affiliation(s)
- Nathan Zelyas
- ProvLab Alberta, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440 112 St, Edmonton, AB T6G 2J2, Canada
| | - Sandy Shokoples
- ProvLab Alberta, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440 112 St, Edmonton, AB T6G 2J2, Canada
| | - Joel Droogers
- Department of Laboratory Medicine & Pathology, University of Alberta, 8440 112 St NW, Edmonton, AB T6G 2R7, Canada
| | - Roberta Lundeberg
- ProvLab Alberta, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440 112 St, Edmonton, AB T6G 2J2, Canada
| | - Duane Leedell
- Department of Laboratory Medicine & Pathology, University of Alberta, 8440 112 St NW, Edmonton, AB T6G 2R7, Canada
| | - Steven J Drews
- ProvLab Alberta, Walter Mackenzie Health Sciences Centre, University of Alberta Hospital, 8440 112 St, Edmonton, AB T6G 2J2, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, 8440 112 St NW, Edmonton, AB T6G 2R7, Canada
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Siow WT, Koay ESC, Lee CK, Lee HK, Ong V, Ngerng WJ, Lim HF, Tan A, Tang JWT, Phua J. The Use of Polymerase Chain Reaction Amplification for the Detection of Viruses and Bacteria in Severe Community-Acquired Pneumonia. Respiration 2016; 92:286-294. [DOI: 10.1159/000448555] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 07/20/2016] [Indexed: 11/19/2022] Open
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Respiratory Outbreak Investigations: How Many Specimens Should Be Tested? Infect Control Hosp Epidemiol 2015; 36:1344-7. [DOI: 10.1017/ice.2015.171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To determine the optimal number of specimens for virus detection in a respiratory outbreak, laboratory results from 2 Canadian public health laboratories were reviewed. The evidence suggests that 3 specimens are sufficient for detection of a virus in >95% of outbreaks, thereby reducing laboratory costs.Infect. Control Hosp. Epidemiol. 2015;36(11): 1344–1347
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