Comparison of Polyurethane Foam to Nylon Flocked Swabs for Collection of Secretions from the Anterior Nares in Performance of a Rapid Influenza Virus Antigen Test in a Pediatric Emergency Department

Scansen, Kimberly A.; Bonsu, Bema K.; Stoner, Erin; Mack, Kathy; Salamon, Douglas; Leber, Amy; Marcon, Mario J.

doi:10.1128/jcm.01897-09

Cited by 36 publications

(29 citation statements)

References 27 publications

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“…The objective of this study was to evaluate the clinical sensitivity and specificity of the Alere i influenza A&B test versus PCR results from residual frozen nasopharyngeal (NP) swab specimens eluted in UTM (NP UTM) from Rhode Island Hospital (RIH) patients. Evaluation of NP UTM specimens is appropriate, as it is a common respiratory sample collection method for many laboratories, since it allows for subsequent testing without the need to collect additional samples from the patient (6,7).…”

mentioning

confidence: 99%

Performance of the Molecular Alere i Influenza A&B Test Compared to That of the Xpert Flu A/B Assay

Chapin

Flores-Cortez

2015

J Clin Microbiol

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bData on the performance of rapid molecular point-of-care use platforms for diagnosis of influenza are lacking. We validated nasopharyngeal (NP) flocked specimens in universal transport medium (UTM) and evaluated the clinical sensitivity and specificity of the Alere i influenza A&B test compared to those of the Xpert flu A/B assay. The Alere i influenza A&B test had an overall sensitivity and specificity of 93.8% and 62.5% for influenza A, respectively, and of 91.8% and 53.6% for influenza B, respectively. The poor specificity was due to influenza virus samples determined positive for both type A and B. R apid and accurate diagnoses of influenza prompt necessary infection control, public health notification, tracking, and accurate administration of antiviral therapy. During the pandemic H1N1 outbreak of 2009, the performance of rapid antigen detection tests for influenza was shown to be inferior to the performance of molecular methods, with sensitivity ranging from 10% to 70% (1-3). Rapid molecular testing was not available in many hospitals, clinics, and physician offices due to either cost of equipment or cost of reagents, use of complex molecular diagnostics requiring skilled technologists to perform testing, and/or slow turnaround time to results (2, 4, 5). Recently, the Alere i influenza A&B assay (Alere, Scarborough, ME) became a FDA-cleared molecular test for detection of influenza viruses A and B.The Alere i influenza A&B system (Alere i system) is a rapid, semiautomated in vitro diagnostic test for the detection and differentiation of influenza A virus and influenza B virus with objective results available in less than 15 min. The Alere i system incorporates isothermal nucleic acid amplification technology using primers and fluorescent probes specific for amplification of RNA targets for influenza A and B virus in samples from patients presenting with influenza-like illness (ILI). The test is performed with an Alere i instrument and three test components: sample receiver, containing elution buffer, test base with two sealed reaction tubes containing a lyophilized pellet containing reagents for amplification of target RNA, and a transfer cartridge for transferring the eluted sample to test base. The Alere i influenza A&B test is intended for direct nasal swab specimen testing for influenza A and B viral infections in conjunction with clinical and epidemiological risk factors. Similar to the earlier IQuum Liat influenza A/B assay (Roche Diagnostics, Indianapolis, IN), the Alere i system was developed to address the unmet clinical need for rapid point-of-care testing of influenza at clinical sites with low test volume and limited easy-to-use molecular technology. Performance characteristics of such devices are lacking, as well as comparisons to traditional PCR methods.The Alere i influenza A&B assay is equipped with sterile-foamtipped applicator swabs (Puritan Medical Products LLC, Guilford, ME) for fresh specimen collection; however, rayon or flocked nasal swabs have been validated for use by Alere. Speci...

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mentioning

confidence: 99%

Performance of the Molecular Alere i Influenza A&B Test Compared to That of the Xpert Flu A/B Assay

Chapin

Flores-Cortez

2015

J Clin Microbiol

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“…With PCR as the gold standard, viral culture carried out at the UHL NHS Trust laboratory had a sensitivity of just 21.6% (95% CI 13.5% to 31.6%), which, although similar to the sensitivity reported by the Portuguese national surveillance network, during the 7-year period 1992-93 to 1998-99, 146 is suboptimal in comparison with sensitivities of 61-96% reported in nine studies 90,91,[147][148][149][150][151][152][153] (Table 24) that were identified for the systematic review and meta-analysis of POCTs for influenza (see Chapter 6). However, the sensitivity of viral culture was similar to that of the Quidel POCT (24.4%, 95% CI 16% to 34.6%).…”

Section: Discussionmentioning

confidence: 63%

“…Scansen et al 90 compared the performance of the Quidel QuickVue Influenza A + B test on secretions from the anterior nares when a polyurethane foam swab was used for collection to that of a nylon flocked swab. The QuickVue test was positive for 40 foam and 30 flocked swabs, for sensitivities of 71% and 54%, respectively, a difference that achieved statistical significance.…”

Section: Patient Outcomesmentioning

confidence: 99%

Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds

Nicholson

Abrams

Batham

et al. 2014

Health Technology Assessment

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“…Two relatively recent notable technologies are the use of flocked swabs and FTA cards (Whatman Inc. Whatman Plc, Maidstone, Kent UK). Flocked swabs are composed of a nylon material that is claimed to have superior capture and release characteristics compared with conventional swabs, thus improving sensitivity by increasing the amount of analyte in the sample (Daley et al, 2006;Dalmaso et al, 2008;Scansen et al, 2010). FTA cards have probably had the greatest impact on sample collection and transport of any technology in past decade.…”

Section: E Spackmanmentioning

confidence: 98%

Viral diagnostics: will new technology save the day?

Spackman

2012

Avian Pathology

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Comparison of Polyurethane Foam to Nylon Flocked Swabs for Collection of Secretions from the Anterior Nares in Performance of a Rapid Influenza Virus Antigen Test in a Pediatric Emergency Department

Cited by 36 publications

References 27 publications

Performance of the Molecular Alere i Influenza A&B Test Compared to That of the Xpert Flu A/B Assay

Performance of the Molecular Alere i Influenza A&B Test Compared to That of the Xpert Flu A/B Assay

Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds

Viral diagnostics: will new technology save the day?

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