Comparison of the ID NOWTM Influenza A & B 2, Cobas? Influenza A/B, and Xpert? Xpress Flu Point-of-Care Nucleic Acid Amplification Tests for Influenza A/B Detection in Children

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J Clin Microbiol. 2020 Jan 15. pii: JCM.01611-19. doi: 10.1128/JCM.01611-19. [Epub ahead of print] Comparison of the ID NOW^TMInfluenza A & B 2, Cobas^?Influenza A/B, and Xpert^? Xpress Flu Point-of-Care Nucleic Acid Amplification Tests for Influenza A/B Detection in Children.

Kanwar N¹, Michael J¹, Doran K¹, Montgomery E¹, Selvarangan R².
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Abstract

Early diagnosis of influenza (Flu) virus is critical for patient management and infection control. The ID NOW™ Influenza A & B 2 assay (ID-NOW™; Abbott Laboratories), Cobas^?Influenza A/B nucleic acid test (LIAT; Roche Molecular Systems Inc.), and Xpert^? Xpress Flu (Xpert; Cepheid) are rapid, point-of-care molecular assays for Flu detection. The study aim was to compare the performance of these three commercially available Clinical Laboratory Improvement Amendments (CLIA) waived Flu assays. We prospectively enrolled 201 children <18 years old from January to April 2018 and collected nasopharyngeal swab specimens in viral media. Aliquots were frozen for testing on different diagnostic platforms per manufacturer's instructions. CDC Flu A/B PCR was used as a reference method to evaluate the performance of these three platforms. Among the 201 specimens tested, the CDC Flu A/B PCR assay detected Flu A/B in 107 samples (Flu A: 73, Flu B: 36; Dual Flu A/B positive: 2), while ID-NOW™ detected 102 samples (Flu A: 69, Flu B: 37; Dual Flu A/B positive: 4; Invalid rate: 1/201-0.5%), LIAT assay detected 112 samples (Flu A: 74, Flu B: 38; Invalid rate: 11/201-5.5%), and Xpert detected 112 samples (Flu A: 76, Flu B: 36; Invalid rate: 6/201-3.0%). The overall sensitivities for ID-NOW™/LIAT/Xpert for Flu A detection (93.2%/100%/100%) and Flu B detection (97.2%/94.4%/91.7%) were comparable. Specificity for Flu A and B detection by all methods was >97%. These molecular assays had higher sensitivity when compared to a historical standard-of-care test result from the BD Veritor™ antigen test (Flu A: 79.5%; Flu B: 66.7%).
Copyright ? 2020 American Society for Microbiology.


PMID: 31941689 DOI: 10.1128/JCM.01611-19