Prospective comparison of RT-PCR/ESI-MS to Prodesse ProFlu Plus and Cepheid GenXpert for the detection of Influenza A and B viruses

Abstract

RT-PCR/ESI-MS has previously demonstrated the capability to detect and identify respiratory viral pathogens in nasopharyngeal swabs. This study expands on previous research by performing a prospective evaluation of RT-PCR/ESI-MS to detect and identify Influenza A and B viruses compared to Prodesse ProFlu Plus and combined ProFlu Plus and Cepheid Xpert Flu. ProFlu Plus was also used as a gold standard for comparison for respiratory syncytial virus detection. Using ProFlu Plus as a gold standard, RT-PCR/ESI-MS had sensitivity and specificity of 82.1% (23/28) and 100% (258/258), respectively, for Influenza A, 100% (16/16) and 99.6% (269/270), respectively for Influenza B, and 88.6% (39/44) and 99.6% (241/242) for any Influenza virus. Using matching results from ProFlu Plus and Xpert Flu as a gold standard, RT-PCR/ESI-MS had 85.2% (23/27) and 100% (259/259) sensitivity and specificity respectively for Influenza A, 100% (14/14) and 99.6% (270/272), respectively for Influenza B virus. Overall, RT-PCR/ESI-MS was not as sensitive as the combined gold standard of ProFlu Plus and Xpert Flu, although it has the capability of detecting other respiratory viruses.

Performance evaluation of the Panther Fusion® respiratory tract panel

“…Some of these assays can be used at point-of-care (POCT) and can consist of a limited panel (e.g. Influenza A and B viruses) [4][5][6] or a comprehensive panel detecting a large number of viruses and even atypical respiratory bacteria [7][8][9]. In contrast to some POCT respiratory virus PCR assays, which can be fast and easy to perform, most laboratory developed tests (LDT) require highly qualified personnel to perform and interpret the results, much longer times to result (up to ∼6 h) and more hands-on time because of, among others, separated nucleic acid extraction, amplification, analysis and QC.…”