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J Clin Virol. 2016 Mar 25;79:12-17. doi: 10.1016/j.jcv.2016.03.022. [Epub ahead of print]
Diagnostic performance of influenza viruses and RSV rapid antigen detection tests in children in tertiary care.
Moesker FM1, van Kampen JJ1, Aron G1, Schutten M2, van de Vijver DA1, Koopmans MP1, Osterhaus AD3, Fraaij PL4.
Author information
Abstract
BACKGROUND:
Rapid antigen detection tests (RADTs) are increasingly used to detect influenza viruses and respiratory syncytial virus (RSV). However, their sensitivity and specificity are a matter of debate, challenging their clinical usefulness.
OBJECTIVES:
Comparing diagnostic performances of BinaxNow Influenza AB? (BNI) and BinaxNow RSV? (BNR), to those of real-time reverse transcriptase PCR (RT-PCR), virus isolation and direct immunofluorescence (D-IF) in paediatric patients.
STUDY DESIGN:
Between November 2005 and September 2013, 521 nasal washings from symptomatic children (age <5 years) attending our tertiary care centre were tested, with a combination of the respective assays using RT-PCR as gold standard.
RESULTS:
Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BNI were 69% (confidence interval [CI] [51-83]), 96% [94-97], 55% [39-70] and 98% [96-99] respectively. Of eleven false-negative samples, RT-PCR Ct-values were higher than all RT-PCR positive test results (27 vs 22, p=0.012). Of twenty false-positive samples, none were culture positive and two tested positive in D-IF. Sensitivity, specificity, PPV and NPV for BNR were 79% [73-85], 98% [96-99], 97% [93-99] and 88% [84-91]. Of the 42 false-negative samples the median Ct-value was higher than that of all RT-PCR positive samples (31 vs 23, p<0.0001). Five false-positive samples were detected. Three of these tested positive for RSV in virus isolation and D-IF.
CONCLUSIONS:
RADTs have a high specificity with BNR being superior to BNI. However, their relative low sensitivity limits their usefulness for clinical decision making in a tertiary care paediatric hospital.
Copyright ? 2016 The Authors. Published by Elsevier B.V. All rights reserved.
KEYWORDS:
Influenza; Paediatrics; Rapid antigen detection tests; Respiratory syncytial virus; Tertiary care
PMID: 27045454 [PubMed - as supplied by publisher]
Diagnostic performance of influenza viruses and RSV rapid antigen detection tests in children in tertiary care.
Moesker FM1, van Kampen JJ1, Aron G1, Schutten M2, van de Vijver DA1, Koopmans MP1, Osterhaus AD3, Fraaij PL4.
Author information
Abstract
BACKGROUND:
Rapid antigen detection tests (RADTs) are increasingly used to detect influenza viruses and respiratory syncytial virus (RSV). However, their sensitivity and specificity are a matter of debate, challenging their clinical usefulness.
OBJECTIVES:
Comparing diagnostic performances of BinaxNow Influenza AB? (BNI) and BinaxNow RSV? (BNR), to those of real-time reverse transcriptase PCR (RT-PCR), virus isolation and direct immunofluorescence (D-IF) in paediatric patients.
STUDY DESIGN:
Between November 2005 and September 2013, 521 nasal washings from symptomatic children (age <5 years) attending our tertiary care centre were tested, with a combination of the respective assays using RT-PCR as gold standard.
RESULTS:
Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BNI were 69% (confidence interval [CI] [51-83]), 96% [94-97], 55% [39-70] and 98% [96-99] respectively. Of eleven false-negative samples, RT-PCR Ct-values were higher than all RT-PCR positive test results (27 vs 22, p=0.012). Of twenty false-positive samples, none were culture positive and two tested positive in D-IF. Sensitivity, specificity, PPV and NPV for BNR were 79% [73-85], 98% [96-99], 97% [93-99] and 88% [84-91]. Of the 42 false-negative samples the median Ct-value was higher than that of all RT-PCR positive samples (31 vs 23, p<0.0001). Five false-positive samples were detected. Three of these tested positive for RSV in virus isolation and D-IF.
CONCLUSIONS:
RADTs have a high specificity with BNR being superior to BNI. However, their relative low sensitivity limits their usefulness for clinical decision making in a tertiary care paediatric hospital.
Copyright ? 2016 The Authors. Published by Elsevier B.V. All rights reserved.
KEYWORDS:
Influenza; Paediatrics; Rapid antigen detection tests; Respiratory syncytial virus; Tertiary care
PMID: 27045454 [PubMed - as supplied by publisher]