Respiratory syncytial virus testing capabilities and practices among National Respiratory and Enteric Virus Surveillance System laboratories, United States, 2016
Respiratory syncytial virus testing capabilities and practices among National Respiratory and Enteric Virus Surveillance System laboratories, United States, 2016
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DOI：
10.1016/j.jcv.2018.08.009
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发表时间：
2018-10-01
影响因子：
8.8
通讯作者：
Kim, Lindsay
中科院分区：
文献类型：
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作者：
Allen, Kristen E.;Chommanard, Christina;Kim, Lindsay
背景：检测呼吸道合胞病毒（RSV）的实验室检测方法在敏感性和特异性上存在差异。诊断测试实践可影响RSV疾病的诊断和负担估计。目的：我们调查了2015-2016年参与国家呼吸道和肠道病毒监测系统（NREVSS）的实验室样本，以了解RSV检测、诊断能力和做法。研究设计：我们于2016年秋季通过网络调查平台向NREVSS实验室分发调查问卷。我们通过自我认定的儿童医院实验室（CHL，即附属于儿童医院或在儿童医院内的实验室）或综合医院实验室（GHL，即仅对成人或成人和儿童的标本进行分析的实验室）对调查反馈和分层结果进行了描述性分析。结果：我们在445个符合条件的NREVSS实验室中抽样367个（82.5%），有效率为35.7%；11.5% （n = 15）为chl。与48.7%的ghl相比，所有chl都具有基于pcr的RSV检测能力（p < 0.001），并且这是chl最常用的方法（n = 9, 75.0%）。与chl相比，ghl使用快速抗原检测检测RSV的频率最高（n = 65,60.2%） （p = 0.02, n = 3,25.0%）。几乎一半（n = 41, 48.2%）的ghl报告了来自50岁以上的RADTs成年人的标本提交。结论：实验室检测和诊断能力因实验室自我认定为CHL或GHL而异。许多ghl报告在50岁以上的成年人中使用了radt，与基于pcr的检测相比，这种诊断方法对该人群的敏感性较低。在成人中使用RADT可能会错过RSV病例，并影响诊断和疾病负担估计。
Background: Laboratory tests to detect respiratory syncytial virus (RSV) vary in sensitivity and specificity. Diagnostic testing practices can impact RSV disease diagnosis and burden estimates.Objectives: We surveyed a sample of laboratories that participated in the National Respiratory and Enteric Virus Surveillance System (NREVSS) in 2015-2016 to understand RSV testing, diagnostic capabilities, and practices.Study design: We distributed surveys in fall 2016 to NREVSS laboratories using an internet survey platform. We conducted a descriptive analysis of survey responses and stratified results by self-identified children's hospital laboratories (CHL, i.e. laboratories affiliated with or in a children's hospital) or general hospital laboratories (GHL, i.e. laboratories that performed analysis on specimens from only adults or adults and children).Results: We sampled 367 (82.5%) of 445 eligible NREVSS laboratories with a 35.7% response rate; 11.5% (n = 15) were CHLs. All CHLs had PCR-based assay capability to test for RSV compared to 48.7% of GHLs (p < 0.001), and it was the most frequent method used by CHLs (n = 9, 75.0%). GHLs used rapid antigen detection tests most frequently (n = 65, 60.2%) to detect RSV compared to CHLs (p = 0.02, n = 3, 25.0%). Almost half (n = 41, 48.2%) of GHLs reported specimen submission from adults >= 50 years for RADTs.Conclusions: Laboratory testing and diagnostic capabilities differed by whether laboratories self-identified as a CHL or GHL. Many GHLs reported use of RADTs in adults >= 50 years, a less sensitive diagnostic method for this population compared to PCR-based assays. RADT use in adults might miss RSV cases and affect diagnoses and disease burden estimates.