Near point-of-care administration by the attending physician of the rapid influenza antigen detection immunochromatography test and the fully automated respiratory virus nucleic acid test: contribution to patient management

Diagn Microbiol Infect Dis. 2013 Aug;76(4):445-9. doi: 10.1016/j.diagmicrobio.2013.04.029. Epub 2013 Jun 3.

Abstract

Rapid influenza antigen detection tests (RIADTs) using immunochromatography are the most readily available tools for the diagnosis and management of influenza. This study was designed to assess whether near point-of-care administration by primary care physicians of the RIADT and a fully automated respiratory virus nucleic acid test (Verigene Respiratory Virus Plus®; RV+) would contribute to improved patient management. When viral culture and RT-PCR/bi-directional sequencing were used as the gold standard, sensitivities and specificities for RIADT and RV+ were 58.3% and 90.9%, and 97.2% and 100%, respectively. Within 12 hours from onset of fever, sensitivities were 44.4% and 94.4%, respectively, for RIADT and RV+. In clinical situations where a higher-sensitivity test is needed, such as during pre-admission evaluations, for testing of hospital employees during the prodromal phase of infection, during the therapeutic decision-making process, and during outbreaks, we suggest that patients testing negative by the RIADT can be reassessed with the RV+ test to achieve maximal diagnostic accuracy.

Keywords: Fully automated respiratory virus Nucleic acid test; Influenza; Near point-of-care; Physician administered; Rapid influenza antigen detection Test by immunochromatography.

MeSH terms

  • Adult
  • Chromatography, Affinity / standards
  • Diagnosis, Differential
  • Diagnostic Techniques, Respiratory System / standards*
  • Female
  • Humans
  • Influenza A virus / isolation & purification*
  • Influenza B virus / isolation & purification
  • Influenza, Human / diagnosis*
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques / standards*
  • Point-of-Care Systems / standards
  • Respiratory Syncytial Virus Infections / diagnosis
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Viruses / isolation & purification
  • Sensitivity and Specificity