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Comparison of the Cepheid Xpert Xpress Flu/RSV assay and commercial real-time PCR for the detection of influenza A and influenza B in a prospective cohort from China

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  • Comparison of the Cepheid Xpert Xpress Flu/RSV assay and commercial real-time PCR for the detection of influenza A and influenza B in a prospective cohort from China

    Int J Infect Dis. 2019 Jan 8. pii: S1201-9712(19)30005-0. doi: 10.1016/j.ijid.2018.12.014. [Epub ahead of print]
    Comparison of the Cepheid Xpert Xpress Flu/RSV assay and commercial real-time PCR for the detection of influenza A and influenza B in a prospective cohort from China.

    Zou X1, Chang K1, Wang Y1, Li M1, Zhang W1, Wang C1, Lu B1, Xiong Z1, Han J1, Zhang Y1, Zhao J1, Cao B2; for CAP-China Network.
    Author information

    Abstract

    BACKGROUND:

    The Xpert Xpress Flu/RSV assay is released by FDA for rapid detection of influenza A (FluA), influenza B (FluB), and respiratory syncytial virus (RSV). This study aimed to evaluate its clinical performance in comparison to that of the RT-PCR assay cleared by China FDA (CFDA-PCR).
    METHODS:

    Nasopharyngeal specimens were collected from patients and tested by the two assays side by side. Discordant results were tested with a laboratory-developed real-time PCR for resolution. Viral load in the sample was quantified with a droplet digital PCR.
    RESULTS:

    A total of 658 specimens were involved and gave 94.7% ∼ 99.1% agreement between the two assays. The Xpert assay showed higher sensitivity for FluA (100% vs. 89.8%) and FluB detection (100% vs. 95.3%), and also higher accuracy (98.9% vs. 95.7%) for FluA than the CDFA-PCR. The positive and negative predictive values (NPV) for the three viruses ranged from 90.5% to 100% in the two assays, with higher NPV for FluA and FluB in Xpert assay. Moreover, the Xpert Ct values showed a linear correlation with virus titer in specimens tested.
    CONCLUSION:

    Overall, the Xpert assay is a reliable and sensitive tool for the detection of FluA, FluB and RSV in our clinical settings.
    Copyright ? 2019. Published by Elsevier Ltd.


    KEYWORDS:

    RT-PCR; Xpert Xpress Flu/RSV; digital PCR; sensitivity

    PMID: 30634045 DOI: 10.1016/j.ijid.2018.12.014
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