1887

Abstract

Although infections with the novel pandemic 2009 influenza A (H1N1) virus (A/H1N1/2009) appeared to be relatively mild during the first summer of circulation (‘off season’), there has been significant morbidity and hospitalization and several fatal cases. Thus, rapid detection of A/H1N1/2009 is crucial for efficient treatment and infection control measures. In contrast to seasonal influenza, where point-of-care (POC) rapid antigen tests and direct fluorescent antibody (DFA) staining ensure rapid detection, diagnosis of A/H1N1/2009 has so far been based on RT-PCR. This study retrospectively compared the performance of the Quidel QuickVue POC test, DFA staining and virus isolation with that of RT-PCR for A/H1N1/2009 detection in 526 respiratory specimens collected during the first wave of the outbreak from May to September 2009. A/H1N1/2009 was detected in 9.1 % (48/526) of samples. One hundred and thirty-seven of the A/H1N1/2009 PCR-negative samples were additionally tested using a RealAccurate Respiratory RT-PCR panel, revealing other respiratory viruses (mainly entero/rhino- and adenoviruses) in 42.3 % (58/137). All methods analysed detected A/H1N1/2009 with excellent specificity but different sensitivities (POC test: 18.2 %; DFA staining: 38.7 %; virus isolation: 45.7 %). Therefore, the POC test was not suitable for diagnosis, detecting A/H1N1/2009 only if present in high concentrations (corresponding median value=19.0; range=16.5–21.4). DFA staining was also able to detect A/H1N1/2009 in specimens with a lower virus concentration (median value=24.0; range=16.5–29.8). Virus isolation, which was positive after a median time of 7.5 days, was too time-consuming. In summary, DFA staining is superior to POC testing and may be appropriate for patients expected to have a rather high level of virus replication. Nevertheless, in DFA-negative specimens, A/H1N1/2009 should be excluded by RT-PCR.

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2010-06-01
2020-01-22
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References

  1. Barenfanger, J., Drake, C., Leon, N., Mueller, T. & Troutt, T. ( 2000; ). Clinical and financial benefits of rapid detection of respiratory viruses: an outcomes study. J Clin Microbiol 38, 2824–2828.
    [Google Scholar]
  2. Chowell, G., Bertozzi, S. M., Colchero, M. A., Lopez-Gatell, H., Alpuche-Aranda, C., Hernandez, M. & Miller, M. A. ( 2009; ). Severe respiratory disease concurrent with the circulation of H1N1 influenza. N Engl J Med 361, 674–679.[CrossRef]
    [Google Scholar]
  3. Costafreda, M. I., Bosch, A. & Pinto, R. M. ( 2006; ). Development, evaluation, and standardization of a real-time TaqMan reverse transcription-PCR assay for quantification of hepatitis A virus in clinical and shellfish samples. Appl Environ Microbiol 72, 3846–3855.[CrossRef]
    [Google Scholar]
  4. D'Heilly, S. J., Janoff, E. N., Nichol, P. & Nichol, K. L. ( 2008; ). Rapid diagnosis of influenza infection in older adults: influence on clinical care in a routine clinical setting. J Clin Virol 42, 124–128.[CrossRef]
    [Google Scholar]
  5. Drexler, J. F., Helmer, A., Kirberg, H., Reber, U., Panning, M., Muller, M., Hofling, K., Matz, B., Drosten, C. & other authors ( 2009; ). Poor clinical sensitivity of rapid antigen test for influenza A pandemic (H1N1) 2009 virus. Emerg Infect Dis 15, 1662–1664.[CrossRef]
    [Google Scholar]
  6. Faix, D. J., Sherman, S. S. & Waterman, S. H. ( 2009; ). Rapid-test sensitivity for novel swine-origin influenza A (H1N1) virus in humans. N Engl J Med 361, 728–729.[CrossRef]
    [Google Scholar]
  7. Fraser, C., Donnelly, C. A., Cauchemez, S., Hanage, W. P., Van Kerkhove, M. D., Hollingsworth, T. D., Griffin, J., Baggaley, R. F., Jenkins, H. E. & other authors ( 2009; ). Pandemic potential of a strain of influenza A (H1N1): early findings. Science 324, 1557–1561.[CrossRef]
    [Google Scholar]
  8. Gilsdorf, A. & Poggensee, G. ( 2009; ). Influenza A(H1N1)v in Germany: the first 10,000 cases. Euro Surveill 14, pii=19318
    [Google Scholar]
  9. Ginocchio, C. C., Zhang, F., Manji, R., Arora, S., Bornfreund, M., Falk, L., Lotlikar, M., Kowerska, M., Becker, G. & other authors ( 2009; ). Evaluation of multiple test methods for the detection of the novel 2009 influenza A (H1N1) during the New York City outbreak. J Clin Virol 45, 191–195.[CrossRef]
    [Google Scholar]
  10. Gottlieb, J., Schulz, T. F., Welte, T., Fuehner, T., Dierich, M., Simon, A. R. & Engelmann, I. ( 2009; ). Community-acquired respiratory viral infections in lung transplant recipients: a single season cohort study. Transplantation 87, 1530–1537.[CrossRef]
    [Google Scholar]
  11. Habib-Bein, N. F., Beckwith, W. H., III, Mayo, D. & Landry, M. L. ( 2003; ). Comparison of SmartCycler real-time reverse transcription-PCR assay in a public health laboratory with direct immunofluorescence and cell culture assays in a medical center for detection of influenza A virus. J Clin Microbiol 41, 3597–3601.[CrossRef]
    [Google Scholar]
  12. Hurt, A. C., Baas, C., Deng, Y. M., Roberts, S., Kelso, A. & Barr, I. G. ( 2009; ). Performance of influenza rapid point-of-care tests in the detection of swine lineage A(H1N1) influenza viruses. Influenza Other Respi Viruses 3, 171–176.[CrossRef]
    [Google Scholar]
  13. Jamieson, D. J., Honein, M. A., Rasmussen, S. A., Williams, J. L., Swerdlow, D. L., Biggerstaff, M. S., Lindstrom, S., Louie, J. K., Christ, C. M. & other authors ( 2009; ). H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 374, 451–458.[CrossRef]
    [Google Scholar]
  14. Low, D. ( 2008; ). Reducing antibiotic use in influenza: challenges and rewards. Clin Microbiol Infect 14, 298–306.[CrossRef]
    [Google Scholar]
  15. Noyola, D. E. & Demmler, G. J. ( 2000; ). Effect of rapid diagnosis on management of influenza A infections. Pediatr Infect Dis J 19, 303–307.[CrossRef]
    [Google Scholar]
  16. Panning, M., Eickmann, M., Landt, O., Monazahian, M., Olschlager, S., Baumgarte, S., Reischl, U., Wenzel, J. J., Niller, H. H. & other authors ( 2009; ). Detection of influenza A(H1N1)v virus by real-time RT-PCR. Euro Surveill 14, pii=19329
    [Google Scholar]
  17. Perez-Padilla, R., de la Rosa-Zamboni, D., Ponce de Leon, S., Hernandez, M., Quinones-Falconi, F., Bautista, E., Ramirez-Venegas, A., Rojas-Serrano, J., Ormsby, C. E. & other authors ( 2009; ). Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med 361, 680–689.[CrossRef]
    [Google Scholar]
  18. Pollock, N. R., Duong, S., Cheng, A., Han, L. L., Smole, S. & Kirby, J. E. ( 2009; ). Ruling out novel H1N1 influenza virus infection with direct fluorescent antigen testing. Clin Infect Dis 49, e66–e68.[CrossRef]
    [Google Scholar]
  19. Smit, M., Beynon, K. A., Murdoch, D. R. & Jennings, L. C. ( 2007; ). Comparison of the NOW Influenza A & B, NOW Flu A, NOW Flu B, and Directigen Flu A+B assays, and immunofluorescence with viral culture for the detection of influenza A and B viruses. Diagn Microbiol Infect Dis 57, 67–70.[CrossRef]
    [Google Scholar]
  20. Storch, G. A. ( 2003; ). Rapid diagnostic tests for influenza. Curr Opin Pediatr 15, 77–84.[CrossRef]
    [Google Scholar]
  21. Vaillant, L., La Ruche, G., Tarantola, A. & Barboza, P. ( 2009; ). Epidemiology of fatal cases associated with pandemic H1N1 influenza 2009. Euro Surveill 14, pii=19309
    [Google Scholar]
  22. Vasoo, S., Stevens, J. & Singh, K. ( 2009; ). Rapid antigen tests for diagnosis of pandemic (swine) influenza A/H1N1. Clin Infect Dis 49, 1090–1093.[CrossRef]
    [Google Scholar]
  23. Weigl, J. A., Puppe, W., Meyer, C. U., Berner, R., Forster, J., Schmitt, H. J. & Zepp, F. ( 2007; ). Ten years' experience with year-round active surveillance of up to 19 respiratory pathogens in children. Eur J Pediatr 166, 957–966.[CrossRef]
    [Google Scholar]
  24. Zarocostas, J. ( 2009; ). World Health Organization declares A (H1N1) influenza pandemic. BMJ 338, b2425 [CrossRef]
    [Google Scholar]
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