Comparison of NxTAG Respiratory Pathogen Panel and Anyplex II RV16 Tests for Multiplex Detection of Respiratory Pathogens in Hospitalized Children

Abstract

Childhood acute lower respiratory infections (ALRI) remain as the most important single cause of global burden of disease among pediatric populations and a major cause of child mortality (1-3). It has been estimated that approximately 165 million episodes of ALRI occur globally each year in children aged 0 to 4 years, resulting in 2.1 million deaths (4). Management of these infections requires extensive use of health care and economic resources: viral ALRI alone has been described to account for an expenditure of approximately 2.4 billion dollars annually (3). Rapid etiological diagnosis of ALRI, followed by timely and specific treatment, has the potential to improve clinical outcomes and reduce the duration of hospital stay, as well as reduce unnecessary laboratory testing and antibiotic use (5, 6). However, discerning the causal agent of the infection is challenging in younger children, who typically present with nonspecific clinical symptoms (7,8). Frequent occurrence of mixed viral and bacterial-viral infections at early ages (9, 10) makes etiological diagnosis even more difficult.Nucleic acid amplification techniques are widely acknowledged to contribute improved sensitivity and rapidness over traditional methods such as culture and direct fluorescent antibody detection for diagnosing ALRI (11,12). In recent years, the introduction of novel molecular assays that allow the performance of multiple analyses in one reaction has widened the spectrum of detectable respiratory pathogens while increasing throughput and convenience (13)(14)(15). The NxTAG respiratory pathogen panel (RPP) RUO (Luminex Molecular Diagnostics, Toronto, Ontario, Canada) is a qualitative reverse transcriptase PCR assay capable of detecting and differentiating the following 22 targets in a single patient sample: adenovirus (ADV), bocavirus (BoV), coronavirus (CoV) types 229E/NL63/OC43/HKU1, influenza A virus (IFV-A; including differentiating subtypes H1/H1N1/H3), influenza B virus (IFV-B), metapneumovirus (MPV), parainfluenza virus (PIV) types 1/2/3/4, respiratory syncytial virus (RSV) types A/B, enterovirus/rhinovirus (EV/RV), Chlamydophila pneumoniae, Mycoplasma pneumoniae, and Legionella pneumophila (16). Similarly, Anyplex II RV16 (Seegene, Inc., Seoul, South Korea) is a qualitative multiplex PCR able to detect 16 targets, including AdV, BoV CoV types 229E/NL63/OC43, EV, IFV-A, IFV-B, MPV, PIV types 1 to 4, RSV types A/B, and RV (17). Both NxTAG RPP and Anyplex II RV16 RUO are Conformité Européene (CE)-marked assays. However, while the former has obtained U.S. Food and Drug Administration clearance (except for the Legionella target), the latter is not available in the United States.The primary objective of this study was to evaluate the diagnostic accuracy of NxTAG RPP RUO in comparison to Anyplex II RV16 using respiratory specimens prospectively collected from pediatric patients hospitalized at a referral medical center out of MATERIALS AND METHODS Study design and setting.A cross-sectional study was conducted to analyze nasopharyng...

Practical Guidance for Clinical Microbiology Laboratories: Viruses Causing Acute Respiratory Tract Infections

“…(a) Multiplexing and the utility of identifying mixed infections. Multiplexing of molecular assays can facilitate identification of mixed viral infections (268)(269)(270). Coinfections are defined as the detection of more than one virus in a patient specimen.…”

Mixed viral infections of the respiratory tract; an epidemiological study during consecutive winter seasons

“…The extent of overlap, the possibility of dual infections and associations of mixed respiratory viral infections with clinical and epidemiological data needs further elucidation. Point of Care testing and newer available molecular techniques have improved our ability to detect diverse viruses causing respiratory infections . In a recent study evaluating two different multiplex kits 14.2% of samples tested, harbored viral co‐infections .…”

“…Point of Care testing and newer available molecular techniques have improved our ability to detect diverse viruses causing respiratory infections . In a recent study evaluating two different multiplex kits 14.2% of samples tested, harbored viral co‐infections . Limited studies have evaluated the presence of mixed viral infections at the clinical setting for adult populations.…”

Multiplexed detection and identification of respiratory pathogens using the NxTAG® respiratory pathogen panel

“…Brotons et al compared the diagnostic accuracy of NxTAG RPP to the Anyplex II RV16 assay with 319 prospectively collected nasopharyngeal aspirates [18]. A total of 268 of 319 (84.0%) specimens yielded concordant results.…”