Evaluation of high-throughput digital lateral flow immunoassays for the detection of influenza A/B viruses from clinical swab samples

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J Med Virol. 2019 Nov 7. doi: 10.1002/jmv.25626. [Epub ahead of print] Evaluation of high-throughput digital lateral flow immunoassays for the detection of influenza A/B viruses from clinical swab samples.

Yoo SJ¹, Shim HS², Yoon S², Moon HW².
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1 Department of Laboratory Medicine, Sanggye Paik Hospital, Inje University, Seoul, Korea. 2 Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea.

Abstract

We evaluated the performance of new high-throughput digital lateral flow immunoassays (LFIAs) detecting influenza antigens, and compared them with those of the widely used digital LFIA and the rapid nucleic acid amplification test (NAAT). We tested 199 clinical nasopharyngeal (nasal) swab samples using three LFIA tests (BD Veritor Plus, STANDARD F Influenza A/B FIA, and ichroma TRIAS) and the rapid NAAT (ID NOW Influenza A & B2). Agreements and clinical performances (sensitivity and specificity) were evaluated based on the results of RT-PCR and verification panel. The agreement of each test with RT-PCR was moderate to almost perfect. The sensitivity of ID NOW was significantly higher than that of LFIAs (P=0.0005, 0.0044, and 0.0026 for influenza A and P=0.0044, 0.0026, and 0.0044 for influenza B, respectively). The specificities were not significantly different between the four tests (P>0.05). However, the reference panel suggests that ichroma TRIAS test is more sensitive than the other two LFIA tests. All three LFIA assays performed similarly with no false positives against influenza A. For influenza B, ichroma TRIAS had 2/166 false positives whereas there were no false positives for the other two LFIA tests. Influenza antigen digital LFIAs have advantages in terms of workflow when simultaneous tests are required. Rapid NAAT has higher sensitivity, while new antigen LFIAs are efficient and high-throughput. It is recommended that users select appropriate methods and algorithms according to the number of specimens and laboratory conditions in each clinical laboratory. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.


KEYWORDS:

Influenza virus; Lateral flow immunoassay; Nucleic acid amplification tests; Rapid influenza diagnostic test

PMID: 31696947 DOI: 10.1002/jmv.25626