Immunochromatographic test for detection of adenovirus from respiratory samples: Is it a real solution for pediatric emergency department?

Abstract

Rapid diagnosis of adenoviral respiratory infections is required in order to decide optimal treatment strategies. The adenovirus antigen immunochromatography Adeno Respiratory Card Letitest (Leti diagnostics, Barcelona, Spain), was evaluated versus the shell-vial culture and multiplex PCR (Clart Pneumovir Version 3.0, Genomica, Madrid, Spain), in nasopharyngeal washes and oropharyngeal swabs specimens from subjects with respiratory tract infections. Between April 2011 and November 2012, 224 patients were included. The IC Adeno Respiratory Card Letitest was positive for 77.9% (74 of 95) of patients diagnosed at bedside. Using multiplex-PCR as the reference standard, the overall sensitivity was 77.9% and the specificity was 73.6%. Taking shell-viral culture as the reference method, the Adeno Respiratory Card Letitest (Leti diagnostics, Barcelona, Spain) sensitivity and specificity values were 80.0% and 60.9%, respectively. Using RT-PCR (Clart Pneumovir Version 3.0, Genomica, Madrid, Spain) as the reference standard, the viral culture sensitivity was 53.2% and the specificity was 100%. The Adeno Respiratory Card Letitest (Leti diagnostics, Barcelona, Spain) assay could be a simple and rapid method for antigenic detection of adenovirus in pediatric respiratory samples although it would be necessary to improve the specificity and sensitivity of the test.

Analytical performance of the automated multianalyte point-of-care mariPOC® for the detection of respiratory viruses

“…Antigen detection tests for ADV based on immunochromatography have shown variable analytical results. Romero-Gómez et al (2014) reported moderate sensitivity (80%) and low specificity (60.9%) compared to viral culture and lower sensitivity compared to NAATs (77.9%), whereas Fujimoto et al (2004) found 100% specificity and sensitivities of 95% and 91% compared with viral culture and NAATs, respectively. In our study, mariPOC yielded a sensitivity of 87.5% and a specificity of 98.5% for ADV detection compared with NAATs.…”

“…However, sensitivity may vary depending on the method and/ or type of patient and sample (CDC, 2009;Lieberman et al, 2009;Utokaparch et al, 2011). These assays have also been used for the detection of other respiratory viruses, as hMPV (Matsuzaki et al, 2009) and ADV (Fujimoto et al, 2004;Romero-Gómez et al, 2014), with variable sensitivities. Thus, the routine investigation of these latter viruses by RDTs has not been considered a cost-effective point-of-care approach, since it leads to a significant increase in costs and a more cumbersome processing of respiratory samples in emergency settings.…”

Useful manifestations to detect adenovirus in children with upper respiratory infections: A retrospective study

“…IC kits for adenoviruses have also been used for detecting adenoviruses using nasopharyngeal washes and oropharyngeal swabs from patients with suspected lower respiratory tract infections (LRIs). In this setting, the sensitivity and specificity were 77.9% and 73.6%, respectively, using multiplex PCR as the reference standard 15. This low sensitivity and specificity may be attributable to the difficulty of applying IC kits for adenoviruses to LRIs.…”

Severe Community-acquired Pneumonia Caused by Type 7 Human Adenovirus in Immuno competent Adults

“…HAdVs pneumonia typically is limited to children, immunocompromised hosts, and usually a cluster erupts [4], but with the development of metagenomic next-generation sequencing (mNGS) technology, HAdVs pneumonia has been increasingly found to be involved in sporadic cases and outbreaks of SCAP in adults. Though it is generally self-limited, once it has progressed to severe pneumonia, the fatality rate is extremely high [5,6].…”