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

作者：Antoniol Stephanie; Fidouh Nadhira; Ghazali Aiham; Ichou Houria; Bouzid Donia; Kenway Philippe; Choquet Christophe; Visseaux Benoit; Casalino Enrique^*

来源：Journal of Clinical Virology, 2018, 99-100: 5-9.

DOI：10.1016/j.jcv.2017.12.005

• Rapid influenza diagnostic test
• PCR influenza
• Diagnostic performance
• Emergency department
• Adults
• Elderly

Background: New rapid influenza diagnostic tests (RIDT) are available but their clinical utility in adults has not been validated.
Objectives: To evaluate the diagnostic performances of OSOM (R) 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.
Study design: Of the 1099 patients admitted to the ED with suspected influenza, all having a nasopharyngeal swab tested by the Xpert (R) Flu PCR and then stored at -20 degrees 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.
Results: 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).
Conclusion: Our results show that the Xpert (R) Flu PCR and the OSOM (R) 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.

• 出版日期2018-3