scholarly journals Analytical performances of the AMPLIQUICK® Respiratory Triplex assay for simultaneous detection and differentiation of SARS-CoV-2, influenza A/B and respiratory syncytial viruses in respiratory specimens

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262258
Author(s):  
Ralph-Sydney Mboumba Bouassa ◽  
Serge Tonen-Wolyec ◽  
David Veyer ◽  
Hélène Péré ◽  
Laurent Bélec
Keyword(s):  
Influenza A ◽  
Viral Infections ◽  
Simultaneous Detection ◽  
Influenza B ◽  
The Novel ◽  
Perfect Agreement ◽  
Qualitative Detection ◽  
High Concordance ◽  
Syncytial Virus ◽  
Respiratory Specimens

Although patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A, influenza B and respiratory syncytial virus (RSV) show comparable or very similar manifestations, the therapeutic approaches of these respiratory viral infections are different, which requires an accurate diagnosis. Recently, the novel multiplex real-time reverse transcription-polymerase chain reaction assay AMPLIQUICK® Respiratory Triplex (BioSynex SA, Illkirch-Graffenstaden, France) allows simultaneous detection and differentiation of SARS-CoV-2, influenza A, influenza B, and RSV in respiratory tract samples. We herein evaluated the performance of the AMPLIQUICK® Respiratory Triplex for the detection of the four viruses in respiratory specimens, using Allplex™ Respiratory Panel 1 and 2019-nCoV assays (Seegene, Seoul, Korea) as reference comparator assays. A total of 359 archived predetermined respiratory samples, including 83, 145, 19 and 95 positive specimens for SARS-CoV-2, influenza A, influenza B and RSV respectively, were included. The AMPLIQUICK® Respiratory Triplex showed high concordance with the reference assays, with an overall agreement for SARS-CoV-2, influenza A, influenza B, and RSV at 97.6%, 98.8%, 98.3% and 100.0%, respectively, and high κ values ranging from 0.93 to 1.00, indicating an almost perfect agreement between assays. Furthermore, high correlations of cycle threshold (Ct) values were observed for positive samples of the four viruses between the AMPLIQUICK® Respiratory Triplex and comparator assays, with an overall high agreement between Ct values assessed by Bland-Altman analyses. In conclusion, these observations demonstrate that the multiplex AMPLIQUICK® Respiratory Triplex is a reliable assay for the qualitative detection and differentiation of SARS-CoV-2, influenza A, influenza B, and RSV in respiratory specimens, which may prove useful for streamlining diagnostics during the winter influenza-seasons.

scholarly journals Evaluation of the Xpert Xpress SARS-CoV-2/Flu/RSV assay for simultaneous detection of SARS-CoV-2, Influenza A/B and Respiratory Syncytial Viruses in nasopharyngeal specimens

2021 ◽  
Author(s):  
Eddie Chi-man Leung ◽  
Viola Chi-ying Chow ◽  
May Kin-ping Lee ◽  
Kevin Pui-san Tang ◽  
Daniel Kwok-cheung Li ◽  
...  
Keyword(s):  
Influenza A ◽  
Simultaneous Detection ◽  
Threshold Value ◽  
Influenza B ◽  
Upper Respiratory Tract ◽  
Prevention Measures ◽  
Kappa Value ◽  
High Concordance ◽  
Syncytial Virus ◽  
Value Association

Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A (flu A), influenza B (flu B), and respiratory syncytial virus (RSV) have overlapping clinical presentations, but the approaches to treatment and management of infections caused by these viruses are different. Therefore, rapid diagnosis in conjunction with infection prevention measures is important to prevent transmission of the diseases. Recently, a new Xpert Xpress SARS-CoV-2/Flu/RSV (Xpert 4-in-1) assay enables the detection and differentiation of SARS-CoV-2, flu A, flu B, and RSV in upper respiratory tract specimens. In this study, we evaluated the performance of the Xpert 4-in-1 assay by comparing it with the Xpert Xpress SARS-CoV-2 and Xpert Xpress Flu/RSV assays for the detection of the four viruses in nasopharyngeal (NP) specimens. A total of 279 NP specimens, including 66, 56, 64 and 53 positive specimens for SARS-CoV-2, flu A, flu B and RSV respectively, were included. The Xpert 4-in-1 assay demonstrated high concordance with the comparator assays, with overall agreement for SARS-CoV-2, flu A, flu B, and RSV at 99.64%, 100%, 99.64%, and 100%, respectively, and a high kappa value ranging from 0.99 to 1.00, indicating an almost perfect correlation between assays. The cycle threshold value association between positive samples also showed a good correlation between assays. In conclusion, the overall performance of the Xpert 4-in-1 assay was highly comparable to that of the Xpert SARS-CoV-2 and Xpert Flu/RSV assays for the detection and differentiation of SARS CoV-2, flu A, flu B, and RSV in NP specimens.

scholarly journals Utility and Challenges of a Multi-pathogen Diagnostic Platform for Characterizing Public Health Threats of Severe Acute Respiratory Infections in Six Countries

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S17-S18
Author(s):  
Jennifer Milucky ◽  
Keyword(s):  
Public Health ◽  
Influenza A ◽  
Age Distribution ◽  
Simultaneous Detection ◽  
Case Fatality ◽  
Influenza B ◽  
Upper Respiratory Tract ◽  
Severe Acute Respiratory Infection ◽  
Syncytial Virus ◽  
Multiple Pathogens

Abstract Background Pneumonia causes significant morbidity and mortality worldwide. Comprehensive etiology studies of pneumonia in adults are limited; however, new diagnostics enable simultaneous detection of multiple pathogens in respiratory specimens. Characterizing the public health threat of severe acute respiratory infection (SARI) may enhance global health security. We studied potential etiologies of SARI among adults in six countries over a 12-month period using multi-pathogen diagnostics. Methods We enrolled SARI cases (acute onset of fever and cough, requiring hospitalization, in an adult) from Global Disease Detection sites in Bangladesh, China, Egypt, Guatemala, Kenya, and Thailand and healthy frequency-matched controls (2 controls: 5 cases) by time (onset), age group (18–49, 50–64, 65+ years), and catchment area. Demographics, clinical data, and nasopharyngeal and oropharyngeal specimens were collected from cases and controls. Specimens were tested for 16 viruses and 14 bacteria using Taqman® Array Card, which uses real-time reverse transcriptase polymerase chain reaction. Results We enrolled 2,388 cases and 1,135 controls from Oct 2013 through Oct 2015. Age distribution (Figure) and seasonality varied by site: enrollment peaked in summer months in Bangladesh, Thailand, and China, and in winter months in Egypt, but was stable throughout the year in Guatemala and Kenya. Case fatality rate across all study locations was 2.3% (range 0–7.0%). One or more pathogens was detected in 76% of cases and in 67% of controls; ≥2 pathogens were detected in 42% of cases and 37% of controls. Pathogens more commonly detected among cases than controls included influenza A (OR 13.3, CI 7.0–25.2; 12.8% of cases vs. 1.1% of controls), influenza B (OR: 27.0, CI 8.6–84.8; 8.1% vs. 0.3%), and respiratory syncytial virus (RSV) (OR: 9.4, CI 3.4–25.8; 4.0% vs. 0.4%). Conclusion In this SARI study, frequent detection of multiple pathogens in the oro- and nasopharynx of both cases and controls made etiology attribution difficult. Influenza and RSV, however, were likely to be causes of SARI. Because upper respiratory tract specimens may not accurately reflect disease in the lung, better specimens are needed to determine pneumonia etiology, particularly for bacteria. Disclosures All authors: No reported disclosures.

scholarly journals Accurate PCR Detection of Influenza A/B and Respiratory Syncytial Viruses by Use of Cepheid Xpert Flu+RSV Xpress Assay in Point-of-Care Settings: Comparison to Prodesse ProFlu+

2017 ◽  
Vol 56 (2) ◽  
Author(s):  
Daniel M. Cohen ◽  
Jennifer Kline ◽  
Larissa S. May ◽  
Glenn Eric Harnett ◽  
Jane Gibson ◽  
...  
Keyword(s):  
Influenza A ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Reverse Transcription Pcr ◽  
Qualitative Detection ◽  
High Concordance ◽  
Respiratory Syncytial Viruses ◽  
Syncytial Virus ◽  
Clinical Laboratory Improvement Amendments

ABSTRACT The Xpert Flu+RSV Xpress Assay is a fast, automated in vitro diagnostic test for qualitative detection and differentiation of influenza A and B viruses and respiratory syncytial virus (RSV) performed on the Cepheid GeneXpert Xpress System. The objective of this study was to establish performance characteristics of the Xpert Flu+RSV Xpress Assay compared to those of the Prodesse ProFlu+ real-time reverse transcription-PCR (RT-PCR) assay (ProFlu+) for the detection of influenza A and B viruses as well as RSV in a Clinical Laboratory Improvement Amendments (CLIA)-waived (CW) setting. Overall, the assay, using fresh and frozen nasopharyngeal (NP) swabs, demonstrated high concordance with results of the ProFlu+ assay in the combined CW and non-CW settings with positive percent agreements (PPA) (100%, 100%, and 97.1%) and negative percent agreements (NPA) (95.2%, 99.5%, and 99.6%) for influenza A and B viruses and RSV, respectively. In conclusion, this multicenter study using the Cepheid Xpert Flu+RSV Xpress Assay demonstrated high sensitivities and specificities for influenza A and B viruses and RSV in ∼60 min for use at the point-of-care in the CW setting.

scholarly journals Performance assessment of Respiratory Viral ELITe MGB® assay for the quantitative detection of influenza A/B and respiratory syncytial viruses

2020 ◽  
Author(s):  
Antonio Piralla ◽  
Federica Giardina ◽  
Alice Fratini ◽  
Davide Sapia ◽  
Francesca Rovida ◽  
...  
Keyword(s):  
Influenza A ◽  
Linear Regression Analysis ◽  
Simultaneous Detection ◽  
Great Majority ◽  
Quantitative Detection ◽  
Total Percentage ◽  
Respiratory Syncytial Viruses ◽  
Syncytial Virus ◽  
Tract Infections ◽  
Respiratory Specimens

AbstractInfluenza (Flu) and respiratory syncytial virus (RSV) are responsible for lower respiratory tract infections (LRTIs) associated with significant hospitalization among young children. In the present study, the performances of a triplex PCR assay detecting Flu A/B and RSV were compared with our in-house single-plex assays using 160 stored respiratory specimens previously tested using a panel of laboratory-developed real-time RT-PCR. Of them, 61 were positive for FluA, 41 for FluB, and 58 for RSV. All samples were retrospectively quantified with Respiratory Viral (RV) ELITe MGB® Panel (ELITechGroup Molecular Diagnostics, Puteaux, France) processed using ELITe InGenius® system. Overall, the total percentage agreement observed was 93.4% (57/61) for FluA, 92.7% (38/41) for FluB, and 86.2% (50/58) for RSV. A significant correlation of VL values was observed between the two methods for FluA and RSV (ρ= 0.91 and 0.84). This finding was supported by the strength of agreement between the two methods, as showed by the linear regression analysis (R2 =0.84 and 0.80). FluB viral load values measured by RV Panel were less significantly correlated (ρ= 0.77 and R2 =0.56). The bland-Altman analysis showed how 84.2% (48/57) of FluA and 86.0% of RSV (43/50) samples fell within ±1.0 Log10 variation from our laboratory results, while only 21.1% (8/38) of FluB results fell within this range. The great majority of FluB samples (29/30) outside range had values higher than +1.0 Log10 (median +2.1 Log10 range +1.0 to +3.5 Log10). In conclusion, RV ELITe MGB® Panel constitutes a valid and robust system for simultaneous detection and quantification of Flu A/B and RSV.

scholarly journals 153. Gone Are the Other Respiratory Viruses During COVID…but the Rhinovirus/Enterovirus “Cockroach” Persists!

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S92-S93
Author(s):  
Jasjit Singh ◽  
Beth Huff ◽  
Delma Nieves ◽  
Wendi Gornick
Keyword(s):  
Influenza A ◽  
Viral Infections ◽  
Respiratory Viruses ◽  
Return To School ◽  
Influenza B ◽  
Respiratory Pathogens ◽  
Free Standing ◽  
California Department ◽  
Syncytial Virus ◽  
Healthcare Associated

Abstract Background In a typical winter respiratory season, Influenza A, Influenza B, Respiratory Syncytial Virus (RSV) and human Metapneumovirus (hMPV) infections are common in pediatrics. During the COVID-19 pandemic, we noted a marked decrease in all except for Rhinovirus/Enterovirus at our free-standing quaternary level children’s hospital. Methods We prospectively reviewed all patients with positive testing for viral respiratory pathogens from October 1, 2018 through May 29, 2021. Testing was done by polymerase chain reaction (PCR) (BioFire® FilmArray® Respiratory 2 Panel, UT) and by SARS-CoV-2 PCR testing (Cepheid®, CA). The latter may have been done for pre-procedure or admission screening. We submitted 74 specimens to the California Department Public Health (CDPH) for definitive identification and serotyping analysis. Results The number of Rhinovirus/Enterovirus (RV/EV) infections was compared with Influenza A & B, RSV, and hMPV over the past 3 years. There was a 152% increase in RV/EV from 2018-2019 to 2020-2021 with near absence of other respiratory viruses (Figure 1). In 2020-2021, RV/EV (N=877, 84%) made up a larger percentage of all viral etiologies compared to 2018-2019 (N=348, 11%) (Figure 2). Healthcare acquired infections (HAI) due to respiratory viruses decreased in 2020-2021 compared to both of the prior seasons, though all cases were due to RV/EV (Figure 3). There were no RV/EV associated deaths. Of 74 submitted, CDPH did typing on 24 samples; all were found to be rhinovirus (RV). Figure 1. High-Risk Winter Viral Infections 2019-2021. Figure 2. Distribution of Winter Viral Pathogens 2018-2019 Compared to 2020-2021 Season. Figure 3. Winter Viral Healthcare Associated Infections 2019-2021. Conclusion We experienced a marked increase in RV/EV during COVID precautions, despite a near absence of other common respiratory viruses. This was reflected in both our community data and HAI due to respiratory viruses. There was a marked increase in RV/EV starting with week 18 (Figure 4). We hypothesize this is due to schools’ re-opening. Understanding RV epidemiology and transmission is important, as it may inform return to school and work protocols for the upcoming respiratory viral season. Figure 4. Rhinovirus/Enterovirus by Week for the 2020-2021 Season. Disclosures All Authors: No reported disclosures

Pneumocystis carinii Pneumonitis in Young Immunocompetent Infants

PEDIATRICS ◽  
1980 ◽  
Vol 66 (1) ◽  
pp. 56-62
Author(s):  
Sergio Stagno ◽  
Linda L. Pifer ◽  
Walter T. Hughes ◽  
Dana M. Brasfield ◽  
Ralph E. Tiller
Keyword(s):  
Influenza A ◽  
Pneumocystis Carinii ◽  
Open Lung Biopsy ◽  
Influenza B ◽  
Severe Respiratory Distress ◽  
Number Of Patients ◽  
Circulating Antigens ◽  
Cytomegalovirus Pneumonia ◽  
Syncytial Virus ◽  
A Prospective Study

Of 67 infants enrolled in a prospective study of infant pneumonia ten (14%) had evidence of Pneumocystis carinii infection. Diagnosis was achieved by demonstrating circulating P carinii antigens by counterimmunoelectrophoresis in all ten cases and by histopathology in the only infant who underwent an open lung biopsy. Antigenemia did not occur in 64 control infants (P = .003), nor in 57 patients of similar age who were hospitalized with pneumonitis due to Chlamydia trachomatis, respiratory syncytial virus, cytomegalovirus, adenovirus, and influenza A and influenza B viruses. None of the ten infants with P carinii pneumonitis had evidence of a primary immunodeficiency nor had any received immunosuppressive medication. These patients were hospitalized at a mean age of 6 weeks (range 2 to 12) and their illness was characterized by its afebrile course, presentation in crisis with severe respiratory distress, apnea, tachypnea, cough, increased IgM, and bilateral pulmonary infiltrates with hyperaeration. The clinical features of P carinii pneumonitis were indistinguishable from those of C trachomatis and cytomegalovirus pneumonia. Treatment with trimethoprim-sulfamethoxazole was associated with rapid disappearance of circulating antigens; however, the small number of patients studied did not permit an analysis of its clinical efficacy. These results indicate that P carinii singly or in combination with other infectious agents may be an important cause of pneumonitis in young, immunocompetent infants with no underlying illnesses.

Clinical use of Antiviral Drugs

1987 ◽  
Vol 21 (5) ◽  
pp. 399-405 ◽  
Author(s):  
Milap C. Nahata
Keyword(s):  
Influenza A ◽  
Viral Infections ◽  
Antiviral Agent ◽  
Antiviral Drugs ◽  
Investigational Drug ◽  
Virus Infections ◽  
Herpes Encephalitis ◽  
Herpes Simplex Viruses ◽  
Varicella Zoster ◽  
Syncytial Virus

Remarkable progress has been made in antiviral chemotherapy. Six approved antiviral drugs are now available for the treatment of various viral infections. Trifluridine, idoxuridine and vidarabine are all effective in patients with herpes keratitis; trifluridine is preferred due to its low toxicity. Acyclovir is the drug of choice in patients with infections due to herpes simplex viruses, including genital herpes, herpes encephalitis, and neonatal herpes, and infections due to varicella-zoster virus. Amantadine is the only drug currently available for prophylaxis and treatment of influenza A, but an investigational drug, rimantadine, appears to be equally effective and less toxic than amantadine. Ribavirin is the most recently approved antiviral agent for the treatment of respiratory syncytial virus infections. Numerous antiviral drugs are being studied in patients with acquired immunodeficiency syndrome. Although currently available drugs have improved our ability to manage a variety of viral illnesses, much needs to be learned about specific dosage guidelines based on the studies of pharmacokinetics, pharmacodynamics, potential adverse effects and viral resistance, and the role of combination therapy to optimize therapy.

scholarly journals Influenza and RSV incidence during COVID-19 pandemic—an observational study from in-hospital point-of-care testing

2021 ◽  
Author(s):  
Paul Stamm ◽  
Ingo Sagoschen ◽  
Kerstin Weise ◽  
Bodo Plachter ◽  
Thomas Münzel ◽  
...  
Keyword(s):  
Emergency Room ◽  
Influenza A ◽  
Point Of Care ◽  
Respiratory Viruses ◽  
Pediatric Emergency ◽  
Influenza B ◽  
Complete Suppression ◽  
Emergency Room Patients ◽  
Syncytial Virus ◽  
Point Of Care Tests

AbstractThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has forced the implementation of unprecedented public health measures strategies which might also have a significant impact on the spreading of other viral pathogens such as influenza and Respiratory Syncytial Virus (RSV) . The present study compares the incidences of the most relevant respiratory viruses before and during the SARS-CoV-2 pandemic in emergency room patients. We analyzed the results of in total 14,946 polymerase chain reaction point-of-care tests (POCT-PCR) for Influenza A, Influenza B, RSV and SARS-CoV-2 in an adult and a pediatric emergency room between December 1, 2018 and March 31, 2021. Despite a fivefold increase in the number of tests performed, the positivity rate for Influenza A dropped from 19.32% (165 positives of 854 tests in 2018/19), 14.57% (149 positives of 1023 in 2019–20) to 0% (0 positives of 4915 tests) in 2020/21. In analogy, the positivity rate for Influenza B and RSV dropped from 0.35 to 1.47%, respectively, 10.65–21.08% to 0% for both in 2020/21. The positivity rate for SARS-CoV2 reached 9.74% (110 of 1129 tests performed) during the so-called second wave in December 2020. Compared to the two previous years, seasonal influenza and RSV incidence was eliminated during the COVID-19 pandemic. Corona-related measures and human behavior patterns could lead to a significant decline or even complete suppression of other respiratory viruses such as influenza and RSV.

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