Evaluation of a New Rapid Antigen Test Using Immunochromatography for Detection of Human Metapneumovirus in Comparison with Real-Time PCR Assay

Abstract

A new rapid human metapneumovirus (hMPV) detection kit using immunochromatography (SAS hMPV test) was compared to real-time PCR for 224 nasal swab specimens, 96.4% of which were obtained from children of <15 years of age. The overall sensitivity and specificity were 82.3% and 93.8%, respectively, suggesting that this test is useful for pediatricians to diagnose hMPV infection in a clinical setting.Human metapneumovirus (hMPV) was first isolated from nasopharyngeal specimens from children with acute respiratory infection (ARI) in 2001, and hMPV has been categorized as a member of the genus Metapneumovirus of the subfamily Pneumovirinae of the family Paramyxoviridae (21). It has been recognized as a common cause of respiratory infections, ranging from upper respiratory tract infections to severe lower respiratory tract infections, in individuals of all ages, though particularly in young children, around the globe (1,3,4,19,21,23,24). Serological studies have indicated that most individuals have been exposed to hMPV by the age of 5 years (15,18,21).hMPV is difficult to detect by cell culture due to its slow growth and weak cytopathic effect. Therefore, reverse transcription-PCR including real-time PCR has been used widely for the detection and laboratory diagnosis of hMPV (22,23). In view of the clinical importance of hMPV, there is a need for a rapid and simple diagnostic method, such as an immunochromatography (IC) test, that can be completed simply in approximately 15 min without any special requirements. At present, IC tests for influenza virus, respiratory syncytial virus (RSV), and adenovirus are widely used for the management of infectious diseases. In this paper, we evaluate the usefulness of a newly developed IC antigen detection kit (SAS hMPV test; SA Scientific, San Antonio, TX) in comparison with the real-time PCR method for the diagnosis of hMPV infection.A total of 224 nasopharyngeal swab specimens were obtained from patients suspected of having an hMPV infection who visited any of three pediatric clinics in Yamagata and Sendai, Japan, between December 2007 and July 2008. Specimens were collected from patients showing symptoms of ARI with fever, cough, and/or rhinorrhea. Specimens that had previously tested positive by rapid antigen test for RSV, influenza A and B viruses, or adenovirus were excluded. Among the 244 specimens, 216 (96.4%) were from children under 15 years of age, with the following overall age distribution: 49 specimens were from children aged under 1 year, 52 were from children aged 1 year, 24 were from children aged 2 years, 21 were from children aged 3 years, 20 were from children aged 4 years, 24 were from children aged 5 years, 19 were from children aged between 6 and 9 years, 7 were from children aged between 10 and 15 years, and 8 were from patients of Ͼ15 years. Specimens were collected from 117 males and 107 females. Two specimens were collected from each patient; one was used for the IC test at the respective clinic, and the other was placed immediately in a tube containing 3...

Seasonal Patterns of Respiratory Syncytial Virus, Influenza A Virus, Human Metapneumovirus, and Parainfluenza Virus Type 3 Infections on the Basis of Virus Isolation Data between 2004 and 2011 in Yamagata, Japan

“…In clinical settings, viral antigen detection kits, which are rapid and easy to use, are particularly helpful in making early decisions regarding management and treatment of the patients. Currently, rapid antigen detection test kits are available for influenza viruses, adenoviruses (Ads), and respiratory syncytial virus (RSV), and an immunochromatographic test kit for human metapneumovirus (hMPV) has recently become commercially available in Japan (8,9).…”

Diagnostic tests for influenza and other respiratory viruses: determining performance specifications based on clinical setting

“…Limitations in rapid antigen testing can be seen with other respiratory viruses, including human metapneumovirus. Although a recent study reported a rapid immunoassay sensitivity and specificity of 82.3 and 93.8%, respectively, for metapneumovirus [27], previous direct antigen detection studies have reported sensitivities ranging from 63.2 to 81% [22,28,29]. The sensitivity of a rapid antigen test is dependent on the reference method with which it is compared.…”

Laboratory Diagnosis for Outbreak-Prone Infectious Diseases after Typhoon Yolanda (Haiyan), Philippines

“…TaqMan real-time PCR was used to detect influenza A virus9, influenza B virus10, respiratory syncytial virus (RSV)11, human metapneumovirus (hMPV)12, norovirus GI/GII13 and dengue virus14. Conventional PCR was used to detect entero/rhinoviruses15 , 16 and chikungunya virus17.…”