Diagnostic performances of the Xpert® Flu PCR test and the OSOM® immunochromatographic rapid test for influenza A and B virus among adult patients in the Emergency Department

•RIDT has a sensitivity and specificity greater than 95% and 98%.•These results are close similar for all circulating strains from the last Influenza epidemic season.•Our results show the utility of RIDT in adults and the elderly.•RIDT can be performed by emergency nurses and physicians. New rapid i...

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Bibliographic Details
Published in:Journal of clinical virology 2018-02, Vol.99-100, p.5-9
Main Authors: Antoniol, Stephanie, Fidouh, Nadhira, Ghazali, Aiham, Ichou, Houria, Bouzid, Donia, Kenway, Philippe, Choquet, Christophe, Visseaux, Benoit, Casalino, Enrique
Format: Article
Language:English
Subjects:
Adult
Adults
Aged
Diagnostic performance
Diagnostic Tests, Routine
Elderly
Emergency department
Emergency Service, Hospital
France - epidemiology
Humans
Immunoassay - standards
Influenza A virus - isolation & purification
Influenza B virus - isolation & purification
Influenza, Human - diagnosis
Influenza, Human - epidemiology
Middle Aged
Molecular Diagnostic Techniques - methods
Molecular Diagnostic Techniques - standards
Nasopharynx - virology
PCR influenza
Point-of-Care Systems
Polymerase Chain Reaction - methods
Rapid influenza diagnostic test
Reproducibility of Results
Sensitivity and Specificity
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Summary:•RIDT has a sensitivity and specificity greater than 95% and 98%.•These results are close similar for all circulating strains from the last Influenza epidemic season.•Our results show the utility of RIDT in adults and the elderly.•RIDT can be performed by emergency nurses and physicians. New rapid influenza diagnostic tests (RIDT) are available but their clinical utility in adults has not been validated. To evaluate the diagnostic performances of OSOM® Ultra Flu A&B a RIDT on viral strains of influenza A/B from the last epidemic season, and its feasibility by Emergency Department (ED) physicians and nurses. Of the 1099 patients admitted to the ED with suspected influenza, all having a nasopharyngeal swab tested by the Xpert® Flu PCR and then stored at −20 °C; 500 were selected at random and their samples were tested using the RIDT. Two experts reviewed ED and hospital medical records and all virological data to define influenza cases. Intra- and inter-observer variability were calculated. Of the 500 patients included 45% were ≥75 years, 122 (24.4%) presented with influenza based on clinical and virological criteria. PCR test performances (%) were Se 98.4 (95% CI 93.6–99.7), Spe 99.7 (98.3–100), PPV 99.2 (94.8–100) and NPV 99.5 (97.9–100); and RIDT performances were Se 95.1 (89.2–97.9), Spe 98.4 (96.4–99.4), PPV 95.1 (87.2–99.9) and NPV 98.4 (96.4–98). There was no difference in test performance between influenza A and B virus nor between the influenza A subtypes. Intra- and inter-observer variability of RIDT were 0.94 (0.89–0.99) and 0.96 (0.92–1). Our results show that the Xpert® Flu PCR and the OSOM® Ultra Flu A&B Test perform very well in diagnosing strains of circulating virus in adults and elderly. Our results also confirm the feasibility of this RIDT at point-of-care by ED staff.
ISSN:1386-6532
1873-5967
DOI:10.1016/j.jcv.2017.12.005