Clinical and Laboratory ObservationHost and Viral Factors Affecting Clinical Performance of a Rapid Diagnostic Test for Respiratory Syncytial Virus in Hospitalized Children
Section snippets
Methods
Children aged 0-35 months hospitalized for acute RTI at the pediatric reference center in Quebec City (population: 747 000), Canada, were enrolled prospectively during 4 consecutive winters (November to April, 2006-2010) following Research Ethics Board approval.9 Clinical data were collected by interview at study entry and after 1-month follow-up; medical records were also reviewed. A nasopharyngeal aspirate was collected at presentation. The specimen was stored at 4°C and tested within 18
Results
Diagnostic test results were available for the RADT and reference standard in 720 of 734 children (98.1%). Mean (±SD) and median patient ages were 8.8 (±8.5) and 5.7 months, respectively.
Annual RSV positivity ranged from 60% to 69% over the four winters. RADT diagnosed 370 of 463 RSV infections (sensitivity 80.0%; 95% CI, 76.0%-83.5%). Among 257 RSV-negative patients, 249 were correctly identified by RADT (specificity 96.9%; 95% CI, 94.0%-98.6%). Positive predictive value was 97.9% (95% CI,
Discussion
Because of their simplicity, speed, and performance characteristics, RSV RADTs are valuable diagnostic tools that are used extensively in clinical laboratories. In 2010-11, RADTs generated two-thirds of the results reported to a RSV surveillance program comprising >200 US diagnostic laboratories.3 Given their widespread use and their public health importance in surveillance, we assessed risk factors for a false-negative RADT result. We observed that patient age, duration of symptoms, and
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Respiratory syncytial virus and metapneumovirus
2023, Molecular Medical Microbiology, Third EditionRespiratory syncytial virus nosocomial outbreak in neonatal intensive care: A review of the incidence, management, and outcomes
2022, American Journal of Infection ControlCitation Excerpt :Some methods such as direct immunofluorescence assays can be conducted rapidly but require laboratory expertise and have poor sensitivity like point-of-care tests that utilize antigen detection. Newer, rapid antigen detection tests are more useful and have a higher sensitivity in infants aged 0-5 months (84%) compared to children aged 24-35 months.49 Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) has a high sensitivity (overall 95%) and the turnaround time is within hours, that facilitate rapid detection of RSVNI during an outbreak.34
A case of respiratory syncytial virus-associated encephalopathy in which the virus was detected in cerebrospinal fluid and intratracheal aspiration despite negative rapid test results
2020, Journal of Infection and ChemotherapyCitation Excerpt :The sensitivity was higher in children (81%) than in adults (29%) [13]. From the studies by Papenburg et al., older age, prolonged symptoms, and RSV type B infection were significantly associated with false-negative results of rapid RSV antigen detection tests [14]. Pfeil et al. analyzed parameters associated with false-negative rapid antigen tests and found that the sensitivity was higher in children < 1-years old compared with children ≥ 1-years old, in children with bronchiolitis compared with children without bronchiolitis, and in children with a shorter duration of symptoms before testing.
Reverse-transcription loop-mediated isothermal amplification for rapid detection of respiratory syncytial virus directly from nasopharyngeal swabs
2017, Journal of Virological MethodsCitation Excerpt :A previous review reported a pooled sensitivity of RADT testing of 80% (95% CI 76%–83%) in pediatric patients (Chartrand et al., 2015), and in a direct comparison of four currently available RADT, the BinaxNow® RSV Card was recommended for the detection of RSV in children (Ohm-Smith et al., 2004). However, RADT sensitivity is strongly dependent on high viral load of respiratory specimens (Papenburg et al., 2013) and therefore works best in young infants with classical symptoms of RSV bronchiolitis (Casiano-Colon et al., 2003; Miernyk et al., 2011; Cruz et al., 2007). Before the introduction of RT-LAMP, we applied BinaxNow® RSV Cards for the detection of RSV in our department.
Diagnostic performance of influenza viruses and RSV rapid antigen detection tests in children in tertiary care
2016, Journal of Clinical VirologyCitation Excerpt :Overall, most studies reported a high specificity and high NPV versus a low sensitivity and low PPV for BNI, which is largely in agreement with our results [5–7,9–12]. We did find a relatively high sensitivity of 79% and an even higher PPV (97%) for BNR, which is in agreement with data obtained in other studies [5,19,20]. During the last decade, RT-PCR has become the gold standard for detecting the presence of respiratory viruses [4].
Interests and limitations of rapid diagnostic tests for respiratory and gastrointestinal viral diseases
2015, Revue Francophone des Laboratoires
Supported by the Canadian Institutes of Health Research (151504 to G.B.) and MedImmune Inc. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. G.B. has received research funds from GlaxoSmithKline, Hoffmann La Roche, and Abbott. D.B. has received research funds from GlaxoSmithKline. G.D.S. has received research funds from GlaxoSmithKline and Sanofi-Pasteur and has participated in an ad hoc GlaxoSmithKline advisory board meeting for which travel expenses were reimbursed. The remaining author declares no conflicts of interest.