Near point-of-care administration by the attending physician of the rapid influenza antigen detection immunochromatography test and the fully automated respiratory virus nucleic acid test: contribution to patient management

Boku, Soushin; Naito, Toshio; Murai, Kazuhiro; Tanei, Mika; Inui, Akihiro; Nisimura, Hidekazu; Isonuma, Hiroshi; Takahashi, Hiroshi; Kikuchi, Ken

doi:10.1016/j.diagmicrobio.2013.04.029

Cited by 18 publications

(12 citation statements)

References 19 publications

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“…However, these tests are time consuming and costly, so they are rarely used clinically in Japan 24. Before introduction of RIADTs to Japan in 1999, physicians diagnosed influenza by assessing clinical symptoms and epidemiological information.…”

Section: Discussionmentioning

confidence: 99%

“…Following the addition of 200 µL of UTM containing materials expressed from the nasopharyngeal swabs, the analysis began; this consisted of a programmed, totally automated extraction, reverse transcriptase-PCR (RT-PCR) and hybridisation sequence. The final readout of the microarray was made by the insertion of the slide array into a reader 24. The result for each virus type, ‘Detected’ or ‘Not detected,’ was displayed on a monitor.…”

Section: Methodsmentioning

confidence: 99%

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Factors influencing the diagnostic accuracy of the rapid influenza antigen detection test (RIADT): a cross-sectional study

et al. 2014

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ObjectiveTo evaluate the diagnostic accuracy of the rapid influenza antigen detection test (RIADT) and determine which symptoms are relevant to results.DesignSingle-centre, cross-sectional study.SettingPrimary care centre, Tokyo, Japan.Participants82 consecutive outpatients presenting with upper respiratory symptoms and fever ≥37°C at any time from symptom onset, between December 2010 and April 2011.Main outcome measuresResults of history and physical examination including age, sex, temperature, time of test from symptom onset, vaccination record and current symptoms (sore throat, arthralgia and/or myalgia, headache, chills, cough and/or throat phlegm, nasal discharge) were recorded. The RIADT and a fully automated respiratory virus nucleic acid test (Verigene Respiratory Virus Plus; VRV), the latter being the gold standard, were performed. Patients were divided into four groups: false negative (FN), RIADT− and VRV+; true positive (TP), RIADT+ and VRV+; true negative (TN), RIADT− and VRV−; and false positive, RIADT+ and VRV−. Groups were compared regarding age, sex, temperature, time of test from symptom onset, vaccination record and symptoms.ResultsRIADT sensitivity, specificity, positive predictive value and negative predictive value were 72.9% (95% CI 61.5% to 84.2%), 91.3% (79.7% to 102.8%), 95.6% (89.5% to 101.6%) and 56.8% (40.8% to 72.7%), respectively. Time from symptom onset to test was shorter for the FN group than the TP group (p=0.009). No significant differences were detected for the other factors assessed. Results revealed higher temperatures for FN than TN patients (p=0.043), and more FN than TN patients had chills (p=0.058).ConclusionsThe RIADT sensitivity was low, due to early administration of the test. In the epidemic season, the RIADT should not be used for suspected influenza until 12 h after symptom onset. A positive RIADT firmly supports the influenza diagnosis; a negative result does not confirm its absence. High fever and chills might indicate influenza, but additional tests are sometimes necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Factors influencing the diagnostic accuracy of the rapid influenza antigen detection test (RIADT): a cross-sectional study

et al. 2014

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“…While enzyme immunoassay based point-of-care tests (POCTs) for influenza and RSV have been available for several years, a health technology appraisal found little benefit of using these devices in a near-patient setting (Nicholson et al, 2014). Moreover, these tests have lower sensitivities compared to PCR-based devices (Boku et al, 2013;DiMaio et al, 2012;Goldenberg and Edgeworth, 2015). A new multiplex PCR-based POCT, Enigma® MiniLab™ FluAB-RSV PCR assay (Enigma Diagnostics Ltd, Salisbury, UK), became available in 2015.…”

Section: Introductionmentioning

confidence: 99%

Impact of a multiplex PCR point-of-care test for influenza A/B and respiratory syncytial virus on an acute pediatric hospital ward

Vecino-Ortiz

Goldenberg

Douthwaite

et al. 2018

Diagnostic Microbiology and Infectious Disease

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Patients with respiratory infections are often managed presumptively until confirmation of infection status. We assessed the impact of introducing the Enigma® MiniLab™ FluAB-RSV point-of-care test (POCT) on patients admitted with a suspected respiratory virus driven illness in an acute pediatric ward. This utilized a before and after design (respiratory viral seasons 2013/14 versus 2014/15). Following POCT implementation, oseltamivir prescribing increased in patients with influenza (OR = 12.7, P = 0.05, 95% CI [1.0, 153.8]). A reduction in the average reimbursement charges without a change in the length of stay was observed. Modeling suggested that laboratory test cost savings could be achieved if the POCT cost £30 and was used for screening, followed by the respiratory viral panel for RSV and influenza negative patients. A rapid POCT for influenza A/B and RSV infections in pediatric inpatients may improve oseltamivir prescribing, strengthen antimicrobial stewardship, reduce reimbursement charges and decrease laboratory costs.

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“…Clinical evaluations have reported sensitivities of 96.6% to 100% for influenza virus A, 96.8% to 100% for influenza virus B, and 89.8% to 91.7% for RSV, with specificities of Ͼ96.5% for all targets (100,103,104), which in one comparative study was superior to results for a traditional RT-PCR test (103).…”

Section: Multiplex Nucleic Acid Testsmentioning

confidence: 95%

Emerging Technologies for the Clinical Microbiology Laboratory

2014

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SUMMARY In this review we examine the literature related to emerging technologies that will help to reshape the clinical microbiology laboratory. These topics include nucleic acid amplification tests such as isothermal and point-of-care molecular diagnostics, multiplexed panels for syndromic diagnosis, digital PCR, next-generation sequencing, and automation of molecular tests. We also review matrix-assisted laser desorption ionization–time of flight (MALDI-TOF) and electrospray ionization (ESI) mass spectrometry methods and their role in identification of microorganisms. Lastly, we review the shift to liquid-based microbiology and the integration of partial and full laboratory automation that are beginning to impact the clinical microbiology laboratory.

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Near point-of-care administration by the attending physician of the rapid influenza antigen detection immunochromatography test and the fully automated respiratory virus nucleic acid test: contribution to patient management

Cited by 18 publications

References 19 publications

Factors influencing the diagnostic accuracy of the rapid influenza antigen detection test (RIADT): a cross-sectional study

Factors influencing the diagnostic accuracy of the rapid influenza antigen detection test (RIADT): a cross-sectional study

Impact of a multiplex PCR point-of-care test for influenza A/B and respiratory syncytial virus on an acute pediatric hospital ward

Emerging Technologies for the Clinical Microbiology Laboratory

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