Accuracy and interpretation of rapid influenza tests in children
Accuracy and interpretation of rapid influenza tests in children
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DOI：
10.1542/peds.2006-1694
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发表时间：
2007-01-01
期刊：
影响因子：
8
通讯作者：
Griffin, Marie R.
中科院分区：
文献类型：
--
作者：
Grijalva, Carlos G.;Poehling, Katherine A.;Griffin, Marie R.
背景。流感抗原快速检测（快速检测）可以及时识别感染情况并辅助临床决策。尽管测试结果的解释取决于测试特征和流感流行率，但这些信息在常规临床实践中是有限的。 目的。我们试图评估快速检测最能预测流感感染的时间。方法。新疫苗监测网络招募了2000年10月至2004年9月期间因呼吸道症状或发烧住院的5岁以下儿童。采集鼻咽拭子，通过培养和逆转录聚合酶链反应检测流感病毒。将提供者订购的快速流感检测与标准（培养和逆转录聚合酶链反应）进行比较，以确定其敏感性和特异性。新疫苗监测网络还在2002-2003年和2003-2004年流感季节期间对门诊儿童进行了登记，并确定了有症状儿童的每周流感流行率。估计流感季节期间快速检测的每周预测值的趋势。结果。快速流感检测的总体敏感性为 63%，特异性为 97%。 2002-2003年，有症状的门诊儿童流感患病率最高达到21%，并在大约4周内保持在10%以上。相比之下，2003年和2004年，流感患病率达到峰值60%，并在大约6周内保持在20%以上。当流感流行率≥15%时，快速检测的阳性预测值接近80%，但当流感流行率<10%时，快速检测的阳性预测值降至<70%。结论。流感流行率在季节之间和季节内有所不同。根据我们的估计，当患病率 < 10% 时，快速检测的用途有限。对快速流感检测的适当解释需要当地流感监测www。
BACKGROUND. Influenza rapid antigen detection ( rapid tests) can provide timely identification of infection and aid in clinical decision-making. Although the interpretation of test results depends on test characteristics and influenza prevalence, this information is limited in routine clinical practice.OBJECTIVE. We sought to assess the times at which rapid tests are most predictive of influenza infection.METHODS. The New Vaccine Surveillance Network enrolled children aged < 5 years who were hospitalized with respiratory symptoms or fever from October 2000 through September 2004. Nasal and throat swabs were obtained, and influenza virus was detected by culture and reverse-transcription polymerase chain reaction. Provider-ordered rapid influenza tests were compared with the criterion standard (culture and reverse-transcription polymerase chain reaction) to determine their sensitivity and specificity. The New Vaccine Surveillance Network also enrolled children in outpatient settings during the 2002-2003 and 2003-2004 influenza seasons and determined the weekly influenza prevalence among symptomatic children. Trends in weekly predictive values of the rapid tests were estimated over the influenza seasons.RESULTS. Rapid influenza tests had an overall sensitivity of 63% and specificity of 97%. In 2002-2003, the prevalence of influenza in symptomatic outpatient children peaked at 21% and stayed above 10% for similar to 4 weeks. In contrast, in 2003 2004, influenza prevalence peaked at 60% and remained above 20% for similar to 6 weeks. The positive predictive value of the rapid tests approached 80% when influenza prevalence was >= 15% but decreased to < 70% when influenza prevalence was < 10%.CONCLUSIONS. Influenza prevalence varies between and within seasons. On the basis of our estimates, rapid tests are of limited use when prevalence is < 10%. The appropriate interpretation of rapid influenza tests requires local influenza surveilwww.