tetano
Editor, Senior Moderator
J Clin Virol. 2016 Mar 25;79:12-17. doi: 10.1016/j.jcv.2016.03.022. [Epub ahead of print]
[h=1]Diagnostic performance of influenza viruses and RSV rapid antigen detection tests in children in tertiary care.[/h] Moesker FM[SUP]1[/SUP], van Kampen JJ[SUP]1[/SUP], Aron G[SUP]1[/SUP], Schutten M[SUP]2[/SUP], van de Vijver DA[SUP]1[/SUP], Koopmans MP[SUP]1[/SUP], Osterhaus AD[SUP]3[/SUP], Fraaij PL[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Rapid antigen detection tests (RADTs) are increasingly used to detect influenza viruses and respiratory syncytial virus (RSV). However, their sensitivity and specificity are a matter of debate, challenging their clinical usefulness.
[h=4]OBJECTIVES:[/h] Comparing diagnostic performances of BinaxNow Influenza AB[SUP]?[/SUP] (BNI) and BinaxNow RSV[SUP]?[/SUP] (BNR), to those of real-time reverse transcriptase PCR (RT-PCR), virus isolation and direct immunofluorescence (D-IF) in paediatric patients.
[h=4]STUDY DESIGN:[/h] Between November 2005 and September 2013, 521 nasal washings from symptomatic children (age <5 years) attending our tertiary care centre were tested, with a combination of the respective assays using RT-PCR as gold standard.
[h=4]RESULTS:[/h] Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BNI were 69% (confidence interval [CI] [51-83]), 96% [94-97], 55% [39-70] and 98% [96-99] respectively. Of eleven false-negative samples, RT-PCR Ct-values were higher than all RT-PCR positive test results (27 vs 22, p=0.012). Of twenty false-positive samples, none were culture positive and two tested positive in D-IF. Sensitivity, specificity, PPV and NPV for BNR were 79% [73-85], 98% [96-99], 97% [93-99] and 88% [84-91]. Of the 42 false-negative samples the median Ct-value was higher than that of all RT-PCR positive samples (31 vs 23, p<0.0001). Five false-positive samples were detected. Three of these tested positive for RSV in virus isolation and D-IF.
[h=4]CONCLUSIONS:[/h] RADTs have a high specificity with BNR being superior to BNI. However, their relative low sensitivity limits their usefulness for clinical decision making in a tertiary care paediatric hospital.
Copyright ? 2016 The Authors. Published by Elsevier B.V. All rights reserved.
[h=4]KEYWORDS:[/h] Influenza; Paediatrics; Rapid antigen detection tests; Respiratory syncytial virus; Tertiary care
PMID: 27045454 [PubMed - as supplied by publisher]
[h=1]Diagnostic performance of influenza viruses and RSV rapid antigen detection tests in children in tertiary care.[/h] Moesker FM[SUP]1[/SUP], van Kampen JJ[SUP]1[/SUP], Aron G[SUP]1[/SUP], Schutten M[SUP]2[/SUP], van de Vijver DA[SUP]1[/SUP], Koopmans MP[SUP]1[/SUP], Osterhaus AD[SUP]3[/SUP], Fraaij PL[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Rapid antigen detection tests (RADTs) are increasingly used to detect influenza viruses and respiratory syncytial virus (RSV). However, their sensitivity and specificity are a matter of debate, challenging their clinical usefulness.
[h=4]OBJECTIVES:[/h] Comparing diagnostic performances of BinaxNow Influenza AB[SUP]?[/SUP] (BNI) and BinaxNow RSV[SUP]?[/SUP] (BNR), to those of real-time reverse transcriptase PCR (RT-PCR), virus isolation and direct immunofluorescence (D-IF) in paediatric patients.
[h=4]STUDY DESIGN:[/h] Between November 2005 and September 2013, 521 nasal washings from symptomatic children (age <5 years) attending our tertiary care centre were tested, with a combination of the respective assays using RT-PCR as gold standard.
[h=4]RESULTS:[/h] Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BNI were 69% (confidence interval [CI] [51-83]), 96% [94-97], 55% [39-70] and 98% [96-99] respectively. Of eleven false-negative samples, RT-PCR Ct-values were higher than all RT-PCR positive test results (27 vs 22, p=0.012). Of twenty false-positive samples, none were culture positive and two tested positive in D-IF. Sensitivity, specificity, PPV and NPV for BNR were 79% [73-85], 98% [96-99], 97% [93-99] and 88% [84-91]. Of the 42 false-negative samples the median Ct-value was higher than that of all RT-PCR positive samples (31 vs 23, p<0.0001). Five false-positive samples were detected. Three of these tested positive for RSV in virus isolation and D-IF.
[h=4]CONCLUSIONS:[/h] RADTs have a high specificity with BNR being superior to BNI. However, their relative low sensitivity limits their usefulness for clinical decision making in a tertiary care paediatric hospital.
Copyright ? 2016 The Authors. Published by Elsevier B.V. All rights reserved.
[h=4]KEYWORDS:[/h] Influenza; Paediatrics; Rapid antigen detection tests; Respiratory syncytial virus; Tertiary care
PMID: 27045454 [PubMed - as supplied by publisher]