Predictive Accuracy and Densitometric Analysis of Point-of-Care Immunoassay for Adenoviral Conjunctivitis.

Autor:	Johnson SD; Northeastern State University, Tahlequah, OK, USA., Harthan JS; Illinois College of Optometry, Chicago, IL, USA., Than T; Carl Vinson VA Medical Center, Dublin, GA, USA., Migneco MK; Washington University in St. Louis, St. Louis, MO, USA., Shorter E; University of Illinois at Chicago, IL, USA., Whiteside MM; University of California, Berkeley, CA, USA., Morettin CE; Illinois College of Optometry, Chicago, IL, USA., Olson CK; Fort Sam Houston, San Antonio, TX, USA., Rosemann CA; Fort Sam Houston, San Antonio, TX, USA., Margolis MS; Washington University in St. Louis, St. Louis, MO, USA., Haertter LW; Washington University in St. Louis, St. Louis, MO, USA., Huecker JB; Washington University in St. Louis, St. Louis, MO, USA., Rodic-Polic B; DiaSorin Molecular LLC, Cypress, CA, USA., Buller RS; Washington University in St. Louis, St. Louis, MO, USA., Storch GA; Washington University in St. Louis, St. Louis, MO, USA., Gordon MO; Washington University in St. Louis, St. Louis, MO, USA., Hartwick ATE; Ohio State University, Columbus, OH, USA.
Jazyk:	angličtina
Zdroj:	Translational vision science & technology [Transl Vis Sci Technol] 2021 Aug 02; Vol. 10 (9), pp. 30.
DOI:	10.1167/tvst.10.9.30
Abstrakt:	Purpose: Accurate diagnosis of adenoviral conjunctivitis (Ad-Cs) is important for timely and appropriate patient management to reduce disease transmission. This study assessed the diagnostic accuracy of a commercially available point-of-care adenovirus immunoassay and determined whether its predictive accuracy is influenced by signal intensities of test result bands. Methods: Point-of-care immunoassay (AdenoPlus) testing and quantitative polymerase chain reaction (qPCR) testing was performed on conjunctival swab samples obtained from eyes of 186 eligible adult participants with presumed infectious conjunctivitis and symptoms of ≤4 days. Masked observers assessed signal intensities of the immunoassay test and control bands using densitometry. Results: Ad-Cs was confirmed by qPCR in 28 of the 56 eyes that tested positive on the AdenoPlus, a 50% positive predictive value (95% confidence interval [CI] = 36.9, 63.1). No adenovirus was detected by qPCR in 128 of 130 eyes that tested negative on AdenoPlus, a 98.5% negative predictive value (CI = 96.3, 100). Sensitivity and specificity were 93% (CI = 84.4, 100) and 82% (CI = 76.0, 88.1), respectively. Viral titers significantly correlated with ratio of test band signal intensities (R2 = 0.32, P = 0.002). Higher positive predictive value was associated with higher densitometry ratios (receiver operating characteristic [ROC] area = 0.71; 95% CI = 0.59, 0.83). Conclusions: Densitometric analyses suggest that the diagnostic accuracy of AdenoPlus is influenced by the signal intensity of the test result bands. Visual comparison of the test band intensities by clinicians could reduce the false positive rate of point-of-care immunoassays and aid in the diagnosis of viral infections. Translational Relevance: Ratiometric densitometry of point-of-care immunoassays could aid clinicians' decision making in diagnosing infectious diseases, including Ad-Cs.
Databáze:	MEDLINE
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