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
2021-01-25
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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: p ii–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: p ii–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: p ii–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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