Rapid influenza A testing for novel H1N1: point-of-care performance.

Division of Pediatric Pulmonology, Children's Medical Center at Winthrop University Hospital, Mineola, NY 11501, USA.
Postgraduate Medicine (Impact Factor: 1.97). 01/2010; 122(1):28-33. DOI: 10.3810/pgm.2010.01.2096
Source: PubMed

ABSTRACT The 2009 outbreak of novel influenza A H1N1 reached a pandemic status on June 11, 2009. Early detection is a key factor for management and infection-control practices. Recent studies have suggested a difference in performance of rapid influenza kits for influenza A H1N1. Our goal was to evaluate the performance of the QuickVue influenza A+B test (Quidel Corp., San Diego, CA) in an emergency department setting and determine the most current epidemiologic trends in our community.
Results from 1137 samples for influenza A collected between April 8, 2009 and June 30, 2009 were retrospectively reviewed. Results of QuickVue influenza A+B test were compared with R-Mix viral culture and DFA results. Age distribution and hospitalization rates by age group were analyzed to further delineate the epidemiology of influenza A in a suburban hospital.
The sensitivity of the rapid test was 77%, the specificity was 85%, the positive predictive value was 74%, and the negative predictive value was 87%. We found a similar age distribution for positive influenza tests and admissions when compared with the national Centers for Disease Control and Prevention data.
The QuickVue influenza A+B test is a sensitive assay for the novel H1N1 strain of influenza. In our hospital, the group with highest risk of hospital admission was patients aged < 25 years.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Western industrialised nations face a large increase in the number of older people. People over the age of 60 years account for almost half of the 16.8 million hospital admissions in England from 2009 to 2010. During 2009-10, respiratory infections accounted for approximately 1 in 30 hospital admissions and 1 in 20 of the 51.5 million bed-days.
    Health technology assessment (Winchester, England) 05/2014; 18(36):1-274. · 5.12 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Timely diagnosis of influenza can help clinical management. To examine the accuracy of rapid influenza diagnostic tests (RIDTs) in adults and children with influenza-like illness and evaluate factors associated with higher accuracy. PubMed and EMBASE through December 2011; BIOSIS and Web of Science through March 2010; and citations of articles, guidelines, reviews, and manufacturers. Studies that compared RIDTs with a reference standard of either reverse transcriptase polymerase chain reaction (first choice) or viral culture. Reviewers abstracted study data by using a standardized form and assessed quality by using Quality Assessment of Diagnostic Accuracy Studies criteria. 159 studies evaluated 26 RIDTs, and 35% were conducted during the H1N1 pandemic. Failure to report whether results were assessed in a blinded manner and the basis for patient recruitment were important quality concerns. The pooled sensitivity and specificity were 62.3% (95% CI, 57.9% to 66.6%) and 98.2% (CI, 97.5% to 98.7%), respectively. The positive and negative likelihood ratios were 34.5 (CI, 23.8 to 45.2) and 0.38 (CI, 0.34 to 0.43), respectively. Sensitivity estimates were highly heterogeneous, which was partially explained by lower sensitivity in adults (53.9% [CI, 47.9% to 59.8%]) than in children (66.6% [CI, 61.6% to 71.7%]) and a higher sensitivity for influenza A (64.6% [CI, 59.0% to 70.1%) than for influenza B (52.2% [CI, 45.0% to 59.3%). Incomplete reporting limited the ability to assess the effect of important factors, such as specimen type and duration of influenza symptoms, on diagnostic accuracy. Influenza can be ruled in but not ruled out through the use of RIDTs. Sensitivity varies across populations, but it is higher in children than in adults and for influenza A than for influenza B. Canadian Institutes of Health Research.
    Annals of internal medicine 02/2012; 156(7):500-11. · 16.10 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A point-of-care test (POCT) offers a rapid result to manage a patient immediately. The presumed simplicity of such tests belies observed variation between personnel in performing and interpreting results when not appropriately trained. The number of point-of-care devices being developed for the diagnosis of infectious diseases is increasing; by understanding the limitations associated with their use, such tests for infection control purposes may be possible. To review the expanding repertoire of POCTs for the diagnosis of infectious diseases and to assess their utility as tools to aid in the reduction of hospital-acquired infection and outbreak management. A systematic review using PubMed and Scopus of published literature on the subject of POCTs for the diagnosis of infectious diseases. Although the number of publications describing POCTs is increasing, there remains a paucity of literature describing their use in a clinical setting. Of the literature reviewed, POCTs for the diagnosis of respiratory syncytial virus and norovirus have the greatest utility in an infection control setting, although the data suggest that sensitivity and training issues might be a problem. The future generation of POCT devices is likely to be molecular-based, improving sensitivity but at a significant cost to the user. POCTs have a role in infection control but currently the lack of good, consistent clinical data surrounding their use outside of the laboratory is a limiting factor in their implementation.
    The Journal of hospital infection 08/2013; · 3.01 Impact Factor