Prospective evaluation of three rapid molecular tests for seasonal influenza in patients presenting at an emergency unit
Prospective evaluation of three rapid molecular tests for seasonal influenza in patients presenting at an emergency unit
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DOI：
10.1016/j.jcv.2019.01.003
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发表时间：
2019-02-01
影响因子：
8.8
通讯作者：
Tiran, Beate
中科院分区：
文献类型：
--
作者：
Valentin, Thomas;Kieslinger, Petra;Tiran, Beate
背景：对于感染控制措施，在疑似季节性流感患者入院时，快速准确的诊断至关重要。目的：三种快速分子检测流感A/B RNA的前瞻性比较。研究设计：研究在格拉茨大学医院急诊科就诊的有流感样疾病和住院需求的门诊患者(n=312)。用3mLUTMTM病毒传输培养液(COPAN)采集鼻咽拭子。使用Alere(TM)I型流感A&B(雅培)、Cobas(R)流感A/B(罗氏)和Xpere(R)Xpress Flu/RSV(造父变种)检测样本进行了甲型和乙型流感RNA检测。结果：雅培、罗氏和造父试验的总灵敏度分别为90.5%、96.0%和97.0%，总特异度分别为99.4%、97.6%和98.2%。Abbott和Cepheid试验均为有效结果，而罗氏试验有37例(12.1%)无效。雅培试验、罗氏试验和造父试验的总结果时间分别为18min、22min和32min。结论：雅培试验缺乏敏感性，罗氏试验因大量无效结果而受到影响。总体而言，尽管结果的总时间最长，Cepheid测试显示出在本研究中出现在急诊室的有症状的患者中检测流感病毒RNA的最佳性能。
Background: For infection control measures, rapid accurate diagnostics on admission of patients with suspected seasonal influenza is crucial.Objective: Prospective comparison of three rapid molecular tests for detection of influenza A/B RNA.Study design: Outpatients presenting at the Medical emergency department of Graz University Hospital with influenza-like illness and a requirement for hospitalization (n = 312) were studied. Nasopharyngeal swabs were collected with the 3 mL-version of the UTMTM Viral Transport Medium (Copan). Specimens were tested for influenza A and B RNA using the Alere (TM) i Influenza A & B (Abbott), the cobas (R) Influenza A/B (Roche), and the Xpere (R) Xpress Flu/RSV (Cepheid) tests. Results were compared to those obtained from the same specimen by the Influenza A/B R-GENE (R) (bioMerieux) test based on real-time PCR as reference method.Results: Overall sensitivities of the Abbott, Roche, and Cepheid tests were 90.5%, 96.0%, and 97.0%, overall specificities 99.4%, 97.6%, and 98.2% respectively. With the Abbott and the Cepheid tests, all specimens gave valid results, while the Roche test showed invalid results in 37 (12.1%) specimens. Total time to result for the Abbott, Roche, and Cepheid tests was 18 min, 22 min, and 32 min respectively.Conclusions: The Abbott test lacked sensitivity, the Roche test was impaired by a high number of invalid results. Overall, despite the longest total time to result, the Cepheid test showed the best performance to detect influenza virus RNA in symptomatic patients presenting at an emergency unit in this study.