| Autor: |
van Doorn, H. Rogier, van Kinh, Nguyen, Tuan, Ha Manh, Tuan, Tran Anh, Minh, Ngo Ngoc Quang, Bryant, Juliet E., Hang, Vu thi Ty, Uyen, Le thi Tham, Thinh, Le Quoc, Anh, Tran thi Ngoc, Lan, Nguyen Phu Huong, Trung, Nguyen Vu, Taylor, Walter, Merson, Laura, Wertheim, Heiman F. L., Farrar, Jeremy, Wolbers, Marcel, Chau, Nguyen van Vinh, de Jong, Menno D. |
| Zdroj: |
Journal of Clinical Microbiology; May 2012, Vol. 50 Issue: 5 p1621-1625, 5p |
| Abstrakt: |
ABSTRACTPoint-of-care (POC) diagnostic tests for influenza can considerably shorten the time to clinical decision making. An investigational POC test based on a multiplexed immunoassay was developed by Meso Scale Diagnostics, LLC (MSD), with the objective to make a more sensitive rapid test that can also subtype influenza A viruses (1977 H1, H3, and H5). Between February and November 2010, we conducted a prospective multicenter study at four hospitals in Vietnam and compared the performance of this test to that of the WHO/CDC real-time reverse transcriptase PCR (RT-PCR) on nasal and throat swab specimens from patients presenting with influenza-like illness. Five hundred sixty-three adults and children with a median age of 25 months were enrolled. Sensitivity and specificity of the test with combined results from nasal and throat swab samples were 74.0% (131/177) and 99.7% (351/352), respectively, compared to RT-PCR. The POC test was as sensitive for influenza virus B as for influenza virus A (74.4% [64/86] versus 73.6% [67/91]). The positivity rate was associated with lower cycle threshold values (a marker for higher viral loads), sample type (73.6% for nasal swab versus 52.4% for throat swab), and younger age. A total of 210 (18.7%) out of 1,126 MSD tests failed, and for 34 (6%) of patients, both test samples failed (these were excluded from the performance analysis). Subtyping could be assessed only for influenza virus A/H3N2, as 1977 H1N1 was not circulating at the time and no H5N1-infected patients were enrolled, and was successful only in 9/54 patients infected with H3 influenza virus who had a positive POC test result for influenza virus A. This novel POC test provided highly sensitive detection of influenza viruses A and B compared to the reported sensitivities of other rapid tests. However, 18.7% of tests failed for technical reasons and subtyping for H3 was poor. Drawbacks to the technology include the requirement for a dedicated reader instrument and the need for continual updating of subtyping antibodies within the test array. |
| Databáze: |
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