Effectiveness of two rapid influenza tests in comparison to reverse transcription-PCR for influenza A diagnosis

Abstract

Introduction: The influenza A virus is responsible for high morbidity and mortality in children and adults worldwide. Thus, a rapid, sensitive, and specific diagnosis tool is required. Methodology: An immunofluorescence assay (DFA) and a lateral-flow immunochromatographic assay were compared with RT-PCR for detection of the influenza A virus in 113 nasopharyngeal wash samples obtained from pediatric patients. Samples were collected between July and December 2009, during the pandemic outbreak of influenza A H1N1/09. Results: The sensitivity, specificity, and positive and negative predictive values obtained for the DFA were 68.97%, 76.63%, 75.47%, and 70%, respectively, while the values obtained for the immunochromatographic assay were 58.62%, 81.82%, 77.27%, and 65.22%, respectively. The frequency of the influenza A virus was 51.33%, and a total of 27 samples were positive for the pandemic influenza A H1N1/09. Conclusions: DFA and the immunochromatographic assay can be important tools for patient care during influenza season and in outbreaks as they usually provide results within 45 minutes. Furthermore, positive results in conjunction with the patient's symptoms could provide a correct diagnosis, thus facilitating appropriate patient management. Nonetheless, the results of these assays still require confirmation by RT-PCR.

Prospective and retrospective evaluation of the Cepheid Xpert® Flu/RSV XC assay for rapid detection of influenza A, influenza B, and respiratory syncytial virus

“…However, such tests still require extensive hands-on time and have an average analytical turnaround time of 3-4 hours. Rapid immunochromatographic tests for the detection of viral antigens have an average turnaround time of 20 min, excellent specificity (Sp), but still are hampered by limited sensitivity (Se) that necessitate to confirm negative results using a technique presenting optimal Se (Aslanzadeh et al, 2008;Falsey et al, 2005;Paulson, 2009;Zazueta-Garcia et al, 2014). The GeneXpert system (Cepheid, France) is designed for nucleic acid extraction, RT-PCR amplification, and real-time detection using a single-use disposable cartridge and an automated platform.…”

Influenza-associated paediatric respiratory hospitalizations in China, 1996–2012: a systematic analysis

“…Though studies have shown that PCR is more sensitive than other test methods, ( 31 , 32 ) our pooled results from other testing methods (not including APAAP and immunoassay) had higher positivity than PCR. This may be because the use of PCR was largely limited to the resourceful southern provinces that have lower proportions of influenza-associated hospitalizations compared with the northern provinces.…”

Influenza colloidal gold method and blood routine tests combination for rapid diagnosis of influenza: a decision tree-based analysis

“…This shows that the colloidal gold method alone is insufficient to discriminate between influenza and influenza-like disease. Studies have shown that the PPV range for a rapid influenza test kit is 30-80% 11,12 . Moreover, Eggers et al 13 reported that the sensitivity and NPV of a rapid influenza test were 40-50% and 55-56%, respectively.…”