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Multiplex PCR System for the Rapid Diagnosis of Respiratory Virus Infection: A Systematic Review and Meta-analysis

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  • Multiplex PCR System for the Rapid Diagnosis of Respiratory Virus Infection: A Systematic Review and Meta-analysis

    Clin Microbiol Infect. 2017 Dec 2. pii: S1198-743X(17)30649-3. doi: 10.1016/j.cmi.2017.11.018. [Epub ahead of print]
    Multiplex PCR System for the Rapid Diagnosis of Respiratory Virus Infection: A Systematic Review and Meta-analysis.

    Huang HS1, Tsai CL2, Chang J3, Hsu TC4, Lin S5, Lee CC6.
    Author information

    Abstract

    OBJECTIVES:

    We aim to provide a summary of evidence for the diagnostic accuracies of three multiplex PCR systems (mPCRs): BioFire Filmarray RP (Filmarray), Nanosphere Verigene RV+ test (Verigene) and Hologic Gen-Probe Prodesse assays on the detection of viral respiratory infections.
    METHODS:

    A comprehensive search up to July 1st, 2017 was conducted on Medline and Embase for studies that utilized Filmarray, Verigene and Prodesse for diagnosis of viral respiratory infections. A summary of diagnostic accuracies for the following five viruses were calculated: Influenza A virus (FluA), Influenza B virus (FluB), Respiratory Syncytial Virus (RSV), human Metapneumovirus and Adenovirus. Hierarchical summary receiver operating curves were employed for estimating the viral detection performance per assay.
    RESULTS:

    Twenty studies with a total of 5510 patient samples were eligible for analysis. Multiplex PCRs demonstrated high diagnostic accuracy with area under the ROC curve (AUROC) more than 0.98 for all the above viruses except for Adenovirus (AUROC 0.93). Filmarray, Verigene and ProFlu+ (the only Prodesse assay with enough data) demonstrated a summary sensitivity for FluA of 0.911 (95%CI: 0.848-0.949), 0.949 (95%CI: 0.882-0.979) and 0.954 (95%CI: 0.871-0.985), respectively. The three mPCRs were comparable in terms of detection of FluA.
    CONCLUSIONS:

    Point estimates calculated from eligible studies showed that the three mPCRs (Filmarray, Verigene and ProFlu+) are highly accurate and may provide important diagnostic information for early identification of respiratory virus infections. In patients with low pretest probability for FluA, these three mPCRs can predict a low possibility of infection and may justify withholding empirical antiviral treatments.
    Copyright ? 2017. Published by Elsevier Ltd.


    KEYWORDS:

    multiplex PCR; point-of-care test; respiratory virus Infection

    PMID: 29208560 DOI: 10.1016/j.cmi.2017.11.018
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