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
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
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DOI：
10.1016/j.diagmicrobio.2013.04.029
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发表时间：
2013-08-01
影响因子：
2.9
通讯作者：
Kikuchi, Ken
中科院分区：
文献类型：
--
作者：
Boku, Soushin;Naito, Toshio;Kikuchi, Ken
使用免疫层析的快速流感抗原检测测试（RIADT）是诊断和管理流感最容易获得的工具。本研究旨在评估 RIADT 初级保健医生的近床护理管理和全自动呼吸道病毒核酸检测（Verigene Respiratory Virus Plus (R)；RV+）是否有助于改善患者管理。当使用病毒培养和 RT-PCR/双向测序作为金标准时，RIADT 和 RV+ 的敏感性和特异性分别为 58.3% 和 90.9%、97.2% 和 100%。发热后 12 小时内，RIADT 和 RV+ 的敏感性分别为 44.4% 和 94.4%。在需要更高灵敏度测试的临床情况下，例如在入院前评估期间、在感染前驱阶段对医院员工进行测试、在治疗决策过程中以及在疫情爆发期间，我们建议可以使用 RV+ 测试重新评估 RIADT 测试阴性的患者，以实现最大的诊断准确性。 (c) 2013 Elsevier Inc. 保留所有权利。
Rapid influenza antigen detection tests (RIADTs) using immunochromatography are the most readily available tools for the diagnosis and management of influenza. This study was designed to assess whether near point-of-care administration by primary care physicians of the RIADT and a fully automated respiratory virus nucleic acid test (Verigene Respiratory Virus Plus (R); RV+) would contribute to improved patient management. When viral culture and RT-PCR/bi-directional sequencing were used as the gold standard, sensitivities and specificities for RIADT and RV+ were 58.3% and 90.9%, and 97.2% and 100%, respectively. Within 12 hours from onset of fever, sensitivities were 44.4% and 94.4%, respectively, for RIADT and RV+. In clinical situations where a higher-sensitivity test is needed, such as during pre-admission evaluations, for testing of hospital employees during the prodromal phase of infection, during the therapeutic decision-making process, and during outbreaks, we suggest that patients testing negative by the RIADT can be reassessed with the RV+ test to achieve maximal diagnostic accuracy. (c) 2013 Elsevier Inc. All rights reserved.