COMPARISON OF RAPID DIAGNOSTIC TESTS FOR INFLUENZA WITH VIRUS ISOLATION AND IMMUNOPEROXIDASE ASSAY

1

• COMPARISON OF RAPID DIAGNOSTIC TESTS FOR
  INFLUENZA WITH VIRUS ISOLATION AND
  IMMUNOPEROXIDASE ASSAY
• Martina Havlícková
• Helena Jirincová
• National Influenza Centre Prague

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Rapid laboratory diagnosis of influenza by means
of near patients test

• Antigen detection
• rapid (15-30 minutes)
• widely available
• early picture of influenza outbreak
  (virus
• circulation)
• but variable sensitivity and specificity

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Commercially available kits for detection of
influenza A/B I
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Commercially available kits for detection of
influenza A/B II
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Owerview of used tests

• Izolation in cell culture MDCK
• IPA after 48-72 hours of cultivation on MDCK
• Rapid tests
• QuickVue Influenza AB test
• BinaxNow Influenza A/B
• DirectigenTM Flu AB
• Infl A- Respistrip - just standards A

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Owerview of investigated samples

• ? 100 nasopharyngeal swabs
• Negative AB 53
• Positive A 30
• Positive B 17
• Standards TCID 50

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Comparison of Directigen, QuickVue, NowFlu and
immunoperoxidase assay results SENSITIVITY

• Test influenza A
  influenza B total
  
  
• 
  
  positive
  
• (30
  posit.samples) (17 posit. samples)
• -------------------------------------------------
  ------------------------
• IP assay 27/28 (96)
  16/17 (94) 43/45(95)
• Virus isol. 12/30 (40)
  10/17 (59) 22/47(47)
• Directigen A/B 26/30 (87)
  6/17 (35) 32/47(68)
• QuickVue A/B 29/30 (97)
  11/17(65) 40/47(85)
• NowFLU A/B 22/30 (73)
  2/10 (20) 24/40(60)
• home made ELISA 20/30 (67)
  2/17 (12) 22/47(47)
• (first screening)

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Comparison of Directigen, QuickVue, NowFlu and
immunoperoxidase assay results SPECIFICITY

• Test 53 influenza A
  and B negative samples
  
  
• 
  
  
• 
  influenza A influenza B
• -------------------------------------------------
  ------------------------
• IP assay 0/53
  (100) 0/53 (100)
• Virus isol. 0/53
  (100) 0/53 (100)
• Directigen A/B 3/53 (94)
  0/53 (100)
• QuickVue A/B 1/53 (98)
  0/53 (100)
• NowFLU A/B NT
  NT
• home made ELISA 0/53
  (100) 0/53 (100)
• (first screening)

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Efficacy of IP assay, direct antigen detection
and virus isolation from 3th to 13th week 05

• total swabs IP assay antigen
  virus
• 
  detection isolation
• --------------------------------------------------
  -------------------
• 442 150(34) ? 73(16)
  ? 61(13)

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A/California 7/04H3N2
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B/CR/115/05
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IPA on MDCK cells infected by A/H1N1 after 48
hours of incubtion
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Evaluation of Quick A/B test

• Valid test A
• Valid test B
• Valid test A/B-
• Invalid tests

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Evaluation of BinaxNow Influenza A/B Test
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Evaluation of Directigen Influenza A/B test
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Conclusion

• Simple and rapid influenza tests
• an important contribution to patient
  management?
• appropriate use of antibiotics
  and diagnostic procedure
• useful tool for virological
  surveillance
• results are closely dependend on type
  and quality of
• specimens