Low Sensitivity of Rapid Diagnostic Test for Influenza

Uyeki, Timothy M.; Prasad, Ramakrishna; Vukotich, Charles J.; Stebbins, Samuel; Rinaldo, Charles R.; Ferng, Yu Hui; Morse, Stephen S.; Larson, Elaine; Aiello, Allison E.; Davis, Brian M.; Monto, Arnold S.

doi:10.1086/597828

Cited by 194 publications

(163 citation statements)

References 12 publications

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“…Testing for influenza is at the discretion of the physician, and some children were likely never tested for influenza. Additionally, the influenza rapid antigen test, a common diagnostic method for influenza has a relatively low sensitivity 20 , 21 , 22 , 23 , 24 that could lead to undiagnosed cases. Second, the children were not systematically tested for bacterial, viral, or fungal pathogens, or radiologically confirmed pneumonia, and thus our results are limited by the testing that was performed as part of routine clinical care and postmortem analysis.…”

Section: Discussionmentioning

confidence: 99%

Influenza-associated mortality among children - United States: 2007-2008

Peebles

Dhara

Brammer

et al. 2010

Influenza and Other Respiratory Viruses

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Please cite this paper as: Peebles et al. (2010) Influenza‐associated mortality among children – United States: 2007–2008. Influenza and Other Respiratory Viruses 5(1), 25–31. Background Since October 2004, pediatric influenza‐associated deaths have been a nationally notifiable condition. To further investigate the bacterial organisms that may have contributed to death, we systematically collected information about bacterial cultures collected at non‐sterile sites and about the timing of Staphylococcus aureus specimen collection relative to hospital admission. Methods We performed a retrospective, descriptive study of all reported influenza‐associated pediatric deaths in 2007–2008 influenza season in the United States. Results During the 2007–2008 influenza season, 88 influenza‐associated pediatric deaths were reported. The median age was 5 (range 29 days – 17 years); 48% were <5 years of age. The median time from symptom onset to death was 4 days (range 0–64 days). S. aureus was identified at a sterile site or at a non‐sterile site in 20 (35%) of the 57 children with specimens collected from these sites; in 17 (85%) of these children, specimens yielding S. aureus were obtained within three days of inpatient admission. These 17 children were older (10 versus 4 years, median; P < 0·05) and less likely to have a high‐risk medical condition (P < 0·05) than children with cultures from the designated sites that did not grow S. aureus. Conclusions S. aureus continues to be the most common bacteria isolated from children with influenza‐associated mortality. S. aureus isolates were associated with older age and lack of high‐risk medical conditions. Healthcare providers should consider influenza co‐infections with S. aureus when empirically treating children with influenza and severe respiratory illness.

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Section: Discussionmentioning

confidence: 99%

Influenza-associated mortality among children - United States: 2007-2008

Peebles

Dhara

Brammer

et al. 2010

Influenza and Other Respiratory Viruses

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“…4 Our results of the sensitivity of physicianordered rapid influenza tests (66% among inpatients and 56% among outpatients) fall within the previously reported range. [32][33][34][35] Rapid influenza tests can provide clinically useful results in a timely fashion. However, many factors can influence the accuracy of rapid influenza test results including the pretest probability of influenza based on presenting clinical signs and symptoms, the local prevalence of influenza, the duration of illness, the quality and type of specimen collected, and the criterion standard to which the rapid test is compared.…”

Section: Figurementioning

confidence: 99%

The Burden of Influenza in Young Children, 2004–2009

Poehling

Edwards²,

Griffin³

et al. 2013

Pediatrics

162

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OBJECTIVE: To characterize the health care burden of influenza from 2004 through 2009, years when influenza vaccine recommendations were expanded to all children aged ≥6 months. METHODS: Population-based surveillance for laboratory-confirmed influenza was performed among children aged <5 years presenting with fever and/or acute respiratory illness to inpatient and outpatient settings during 5 influenza seasons in 3 US counties. Enrolled children had nasal/throat swabs tested for influenza by reverse transcriptase-polymerase chain reaction and their medical records reviewed. Rates of influenza hospitalizations per 1000 population and proportions of outpatients (emergency department and clinic) with influenza were computed. RESULTS: The study population comprised 2970, 2698, and 2920 children from inpatient, emergency department, and clinic settings, respectively. The single-season influenza hospitalization rates were 0.4 to 1.0 per 1000 children aged <5 years and highest for infants <6 months. The proportion of outpatient children with influenza ranged from 10% to 25% annually. Among children hospitalized with influenza, 58% had physician-ordered influenza testing, 35% had discharge diagnoses of influenza, and 2% received antiviral medication. Among outpatients with influenza, 7% were tested for influenza, 7% were diagnosed with influenza, and <1% had antiviral treatment. Throughout the 5 study seasons, <45% of influenza-negative children ≥6 months were fully vaccinated against influenza. CONCLUSIONS: Despite expanded vaccination recommendations, many children are insufficiently vaccinated, and substantial influenza burden remains. Antiviral use was low. Future studies need to evaluate trends in use of vaccine and antiviral agents and their impact on disease burden and identify strategies to prevent influenza in young infants.

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“…Araş tır ma cı lar hüc re kül tü rü ve PCR ile kar şı laş tı rı lan ça lış ma lar da inf lu en za hız lı an ti jen test le ri için du yar lı lı ğı %27-70, öz gül lü ğü ise %95-100 ara lı ğın da ver mek te dir ler. 7,12,13 Fa ix ve ark., pan de mik inf lu en za A en fek si yon la rın da hız -lı test ler için du yar lı lı ğı %63, öz gül lü ğü ise % 95 ora nın da bil dir miş ler dir. 12 Uye ki ve ark.…”

Section: Pcr Negatif Pcr Pozitif Toplamunclassified

“…Re al ti me-PCR ve hüc re kül tü rü ile kar şı laş tı rı lan inf lu en za hız lı testin du yar lı lı ğı %27, öz gül lü ğü ise %97 ola rak bulun muş tur. 7 Hurt ve ark. hüc re kül tü rü ile beş hız lı an ti jen tes ti ni (Bi nax Now Inf lu en za A&B, Di recti gen EZ Flu A + B, Den ka Se i ken Qu ick Ex-Flu, Fu ji re bi o Esp li ne Inf lu en za A&B-N, and Qu i del Qu ick Vu e Inf lu en za A + B Test) kar şı laş tır-mış tır.…”

Section: Pcr Negatif Pcr Pozitif Toplamunclassified

“…Re fe rans test ler ile kar şı laş tı rıl -dı ğın da, bu test le rin öz gül lük le ri yük sek, du yarlı lık la rı ise dü şük oran lar da ve ge niş bir ara lık ta bildi ril mek te dir. 7 Bu ça lış ma da eşza man lı al dı ğı mız na zo fa renge al ve bo ğaz sü rün tü ör nek le rin den BD Di rec tigen TM EZ Flu A+B tes ti ile re al ti me-PCR so nuç ları nın kar şı laş tı rıl ma sı ve da ki ka lar için de so nuç veren hız lı an ti jen tes ti nin du yar lı lık ve öz gül lü-ğü nün be lir len me si amaç lan mış tır.…”

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Assessment of DirectigenTM EZ Flu A+B Rapid Antigen Diagnostic Test for Pandemic Influenza A (H1N1)

Berktaş¹,

Çıkman²,

Yaman³

et al. 2011

Turkiye Klinikleri J Med Sci

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Ö ÖZ ZE ET T A Am ma aç ç: : 2009 yı lı yaz ay la rı nın baş lan gı cın da Gü ney ya rım kü re de gö rül me ye baş la nan pan de mik influ en za A (H1N1) ol gu la rı, kış ay la rı na gir di ği miz bu gün ler de Ku zey ya rım kü re de de gi de rek faz la sa yı -da göz len me ye baş lan mış tır. Ye ni an ti je nik ya pı sı ne de niy le sap tan ma sın da zor luk lar ya şa nan bu vi ral has ta lı ğın ta nı sın da kul la nıl mak üze re az sa yı da ba zı ta nı test le ri ge liş ti ril miş tir. Bu test ler den mo le kü ler yön tem ler le ça lı şan la rın du yar lı lık ve öz gül lük le ri nin yük sek ol ma la rı na kar şın pa ha lı test ler ol ma la rı yay gın kul la nım la rı na imkân ver me mek te dir. Bu test le re al ter na tif ola rak ge liş ti ri len hız lı test ler ise ucuz ol ma la rı na kar şın du yar lı lık la rı ne de niy le eleş ti ril mek te dir ler. Bu ça lış ma da hız lı ta nı test le rin den bi ri olan Di rec ti gen EZ Flu A+B tes ti nin pan de mik inf lu en za A (H1N1) en fek si yo nu ta nı sın da ki ye ri araş tı rıl -mış tır.G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Pan de mik inf lu en za A şüp he si acil ser vi se baş vu ran ve ya kli nik ler de ya tan 52 has ta dan eş za man lı alı nan na zo fa ren ge al ve bo ğaz sü rün tü ör nek le ri, hız lı Di rec ti gen EZ Flu A+B an ti jen tes ti (Bec ton Dic kin son, USA) ile bir lik te Infl./H1 LC/RG Re al Ti me-PCR tes ti (Kit, Qi a gen, Ro tor-ge ne Q, Ja pan) ile ça lı şıl mış tır. B Bu ul lg gu ul la ar r: : Çalışmaya alınan toplam 52 hastanın 17 (%33)'sinde Directigen TM EZ Flu A+B ile 35 (%67)'inde ise real time-PCR ile pozitiflik saptanmıştır. PCR ile H1N1 pozitif saptanan 35 hastanın 17 (%49)'sinde hızlı tanı testi ile influenza A pozitif saptanmış, PCR testi ile negatif saptanan tüm olgularda hızlı tanı testi de negatif sonuç vermiştir. Directigen TM EZ Flu A+B testinin H1N1 için duyarlılığı %49, özgüllüğü ise %100 olarak bulunmuştur. S So on nu uç ç: : Directigen TM EZ Flu A+B testi, pandemik influenza A (H1N1) hastalığının tanısında tarama ve ön tanı testi olarak kullanılabilir. Pozitif sonuçlar tanı koydurucu olmasına karşın negatif sonuçların moleküler mikrobiyolojik yöntemlerle doğrulanması gerekmektedir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : İnfluenza A virüsü; H1N1 alttip; polimeraz zincir reaksiyonu A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Pandemic influenza A (H1N1) cases that has begun to be seen in Southern hemisphere at the beginning of summer 2009 is gradually increasing also in Northern hemisphere nowadays, at the beginning of winter. A few diagnostic tests have been developed for diagnosis of this viral disease that is difficultly detected due to its novel antigenic structure. Although sensitivity and specifity of these molecular tests are high, they may not commonly be used as they are expensive. Rapid tests that have been developed alternatively to these tests are criticized because of their low sensitivity although they are cheap. In this study, effectiveness of Directigen EZ Flu A+...

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Low Sensitivity of Rapid Diagnostic Test for Influenza

Cited by 194 publications

References 12 publications

Influenza-associated mortality among children - United States: 2007-2008

Influenza-associated mortality among children - United States: 2007-2008

The Burden of Influenza in Young Children, 2004–2009

Assessment of DirectigenTM EZ Flu A+B Rapid Antigen Diagnostic Test for Pandemic Influenza A (H1N1)

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