Point of care influenza testing using Alere-i Influenza A & B assay: a practical assessment

Abstract

23We assessed the utility of the Alere i Influenza A & B point of care influenza test POCIT) with laboratory testing using RT-PCR. 270 adult hospital patients had both 25Ai-POCIT and laboratory influenza tests conducted on the same sample. Overall, 30% 26 and 32% influenza tests were positive by Ai-POCIT and RT-PCR, respectively. The 27 sensitivity of the Ai-POCIT for influenza A, influenza B and any influenza were 93%, 28 100%, and 95%, respectively. Specificity was 100% for both viruses, but an 11% test 29 failure rate indicates the need for better training of users. We believe that the use of 30 nasopharyngeal (NP) swabs resulted in the observed high performance of the Ai-31 POCIT in comparison to other published studies. Ai-POCIT was regarded as very 32 useful by front line clinical staff for clinical decision making and acute bed 33 management. 34 35 Introduction 36More than most other respiratory infections, the effective inpatient management of 37 influenza relies upon accurate and rapid laboratory diagnosis so that results can 38 influence clinical decisions on infection control precautions, single room use and 39 antivirals or antibiotic use. This is difficult with laboratory-based testing, especially at 40 weekends and evenings unless the molecular diagnostics laboratory has extended 41 hours of operation and runs the assay more than once a day. Traditional nucleic acid 42 amplification tests (NAAT) are run in batches, further delaying test results that miss 43 the cut-off for being included in the batch. Rapid, one-off NAAT in the laboratory can 44 be helpful (1), but specimen transport to the laboratory and workflow issues may 45 make it difficult to achieve clinically useful turnaround times. It may be logistically 46EDs. The primary aim of the study was to establish whether Ai-POCIT was 59 sufficiently reliable in practice to be introduced as an alternative to laboratory-based 60 influenza diagnostics. 61 62 Materials and Methods 63Adult patients being assessed in the ED for admission to medical wards and meeting 64 simple criteria for influenza-like illness (ILI) were included. The criteria for ILI 65 consisted of symptom onset within the past 5 days, with at least one new respiratory 66 symptom (cough, shortness of breath, sore throat, nasal congestion) and at least one 67 new systemic symptom (fevers, rigors, malaise). The study was conducted in winter 68 between July and October 2017, in two ED departments from the largest hospitals in 69 the Wellington region: Wellington and Hutt Hospitals. 70 71

The impact of point-of-care testing for influenza A and B on patient flow and management in a medical assessment unit of a general hospital

“…ID NOW). A number Open Access BMC Research Notes *Correspondence: sjpoconnell@bonsecours.ie 2 Shannon Applied Biotechnology Centre, Institute of Technology Tralee, Tralee, Co. Kerry, Ireland Full list of author information is available at the end of the article of studies have been reported outlining the performance of the Alere I POCT (now known as Abbott ID NOW) NAAT versus laboratory based methods such as thermocycler rtPCR and viral culture for Influenza testing [5][6][7][8][9][10][11][12][13][14][15][16]. These studies have reported influenza A sensitivity in the range of 66-100% and specificity of 55-100%, while for influenza B sensitivity ranged from 45 to 100% and specificity 54-100%.…”

The Impact of Point-of-Care Testing for Influenza A and B on Patient Flow and Management in a Medical Assessment Unit of a General Hospital.

“…ID NOW). A number of studies have been reported outlining the performance of the Alere I POCT (now known as Abbott ID NOW) NAAT versus laboratory based methods such as thermocycler rtPCR and viral culture for Influenza testing [5][6][7][8][9][10][11][12][13][14][15][16].These studies have reported influenza A sensitivity in the range of 66-100% and specificity of 55-100%, while for influenza B sensitivity ranged from 45-100% and specificity 54-100%. The studies comparing ID NOW with the GeneXpert have previously used nasopharyngeal swabs in viral transport medium (VTM) [6][7][8].…”

The Impact of Point-of-Care Testing for Influenza A and B on Patient Flow and Management in a Medical Assessment Unit of a General Hospital.

“…ID NOW). A number of studies have been reported outlining the performance of the Alere I POCT (now known as Abbott ID NOW) NAAT versus laboratory based methods such as thermocycler rtPCR and viral culture for Influenza testing [5][6][7][8][9][10][11][12][13][14][15][16].These studies have reported influenza A sensitivity in the range of 66-100% and specificity of 55-100%, while for influenza B sensitivity ranged from 45-100% and specificity 54-100%. The studies comparing ID NOW with the GeneXpert have previously used nasopharyngeal swabs in viral transport medium (VTM) [6][7][8].…”