Comparison of three multiplex gastrointestinal platforms for the detection of gastroenteritis viruses

Abstract

Background Viruses are major etiological agents of childhood gastroenteritis. In recent years, several molecular platforms for the detection of viral enteric pathogens have become available. Objective/study design We evaluated the performance of three multiplex platforms including Biofire’s Gastrointestinal Panel (FilmArray), Luminex xTAG® Gastrointestinal Pathogen Panel (GPP), and the TaqMan Array Card (TAC) for the detection of five gastroenteritis viruses using a coded panel of 300 archived stool samples. Results The FilmArray detected a virus in 199 (96.1%) and the TAC in 172 (83.1%) of the 207 samples (187 samples positive for a single virus and 20 samples positive for more than one virus) whereas the GPP detected a virus in 100 (78.7%) of the 127 (97 positive for one virus and three positive for more than one virus) samples. Overall the clinical accuracy was highest for the FilmArray (98%) followed by TAC (97.2%) and GPP (96.9%). The sensitivity of the FilmArray, GPP and TAC platforms was highest for rotavirus (100%, 95.8%, and 89.6%, respectively) and lowest for adenovirus type 40/41 (97.4%, 57.9% and 68.4%). The specificity of the three platforms ranged from 95.6% (rotavirus) to 99.6% (norovirus/sapovirus) for the FilmArray, 99.6% (norovirus) to 100% (rotavirus/adenovirus) for GPP, and 98.9% (astrovirus) to 100% (rotavirus/sapovirus) for TAC. Conclusion The FilmArray demonstrated the best analytical performance followed by TAC. In recent years, the availability of multi-enteric molecular testing platforms has increased significantly and our data highlight the strengths and weaknesses of these platforms.

Comparative Evaluation of Seegene Allplex Gastrointestinal, Luminex xTAG Gastrointestinal Pathogen Panel, and BD MAX Enteric Assays for Detection of Gastrointestinal Pathogens in Clinical Stool Specimens

“…Luminex showed 2 false-negative results for norovirus and 8 for rotavirus. This result is in line with previous studies 27,28 showing that Luminex had lower sensitivity in norovirus and rotavirus compared with FilmArray and TaqMan Array Card. Zhuo et al 28 reported that Luminex had lower sensitivity especially in detecting norovirus genotype II, and the 2 false-negative cases in our study were norovirus genotype II by Seegene.…”

Validation of a Laboratory-Developed Triplex Molecular Assay for Simultaneous Detection of Gastrointestinal Adenovirus and Rotavirus in Stool Specimens

“…The lower NPA was a result of 15 specimens in which rotavirus was detected by the rotavirus ICT test, but not by the triplex assay. This could be due to false positive results by the rotavirus ICT test, which are commonly reported for the rotavirus ICT test [32,33]. It could also be due to repeat freeze-thaw of specimens used for this validation study, which could cause genome degradation and lower detection.…”

“…In summary, the triplex assay demonstrated similar performance to the Seegene assay for both adenovirus and rotavirus targets and performed better than traditional testing methods (EM and rotavirus ICT) used at PHO laboratory. The average PPA of the triplex assay detected for adenovirus in comparison to the Seegene assay could be due to mismatches with the viral templates and differences in oligonucleotide primers and probes used by these assay systems [33]. Possible explanations include higher sensitivity of the Seegene assay for adenovirus detection, or alternatively false positive results by Seegene.…”

New Developments in Rapid Diagnostic Testing for Children

“…In another study, the investigators evaluated the FilmArray Gastrointestinal and xTAG Gastrointestinal panels and found similar performance between both tests for shared analytes except the xTAG panel demonstrated lower specificity for norovirus in prospective and retrospective specimens. 33 Finally, in the study by Chhabra and colleagues, 34 the investigators specifically examined the analytical performance of the FilmArray Gastrointestinal and xTAG Gastrointestinal panels for detection of gastrointestinal viruses. The investigators noted that the FilmArray Gastrointestinal Panel demonstrated overall better analytical performance for viral detection relative to the xTAG panel.…”

“…The investigators noted that the FilmArray Gastrointestinal Panel demonstrated overall better analytical performance for viral detection relative to the xTAG panel. 34 Although multiplex gastrointestinal panels offer more rapid results to clinicians, they can present a potential problem for public health surveillance efforts if bacterial pathogens are not cultured. 35 In addition, the lack of bacterial isolates could complicate treatment without antimicrobial susceptibility results.…”