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      Comparing the Cobas Liat Influenza A/B and respiratory syncytial virus assay with multiplex nucleic acid testing

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          Abstract

          Influenza virus and respiratory syncytial virus (RSV) detection with short turn‐around‐time (TAT) is pivotal for rapid decisions regarding treatment and infection control. However, negative rapid testing results may come from poor assay sensitivity or from influenza‐like illnesses caused by other community‐acquired respiratory viruses (CARVs). We prospectively compared the performance of Cobas Liat Influenza A/B and RSV assay (LIAT) with our routine multiplexNAT‐1 (xTAG Respiratory Pathogen Panel; Luminex) and multiplexNAT‐2 (ePlex‐RPP; GenMark Diagnostics) using 194 consecutive nasopharyngeal swabs from patients with influenza‐like illness during winter 2017/2018. Discordant results were reanalyzed by specific in‐house quantitative nucleic acid amplification testing (NAT). LIAT was positive for influenza virus‐A, ‐B, and RSV in 18 (9.3%), 13 (6.7%), and 55 (28.4%) samples, and negative in 108 samples. Other CARVs were detected by multiplexNAT in 66 (34.0%) samples. Concordant results for influenza and RSV were seen in 190 (97.9%), discordant results in 4 (2.1%), which showed low‐level RSV (<40 000 copies/mL). Sensitivity and specificity of LIAT for influenza‐A, ‐B, and RSV were 100%, 100% and 100%, and 100%, 99.5% and 100%, respectively. The average TAT of LIAT was 20 minutes compared to 6 hours and 2 hours for the multiplexNAT‐1 and ‐2, respectively. Thus, LIAT demonstrated excellent sensitivity and specificity for influenza and RSV, which together with the simple sample processing and short TAT renders this assay suitable for near‐patient testing.

          Abstract

          • ‐

            Cobas Liat is highly sensitive and specific for Influenza and RSV in 86/194 children

          • ‐

            Other CARVs were detected by multiplex NAT in 66/196 children

          • ‐

            Simple processing and TAT of 20 min suitable for near‐patient testing

          • ‐

            LIAT assay shows excellent sensitivity and specificity for influenza and RSV

          • ‐

            Simple sample processing and short turn‐around‐time of 20 min render the assay suitable for near‐patient testing

          • ‐

            Barcode reading and direct transfer of results into the laboratory information system

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          The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children.

          K Neuzil, B Mellen, P. Wright … (2000)
          Despite high annual rates of influenza in children, influenza vaccines are given to children infrequently. We measured the disease burden of influenza in a large cohort of healthy children in the Tennessee Medicaid program who were younger than 15 years of age. We determined the rates of hospitalization for acute cardiopulmonary conditions, outpatient visits, and courses of antibiotics over a period of 19 consecutive years. Using the differences in the rates of these events when influenzavirus was circulating and the rates from November through April when there was no influenza in the community, we calculated morbidity attributable to influenza. There was a total of 2,035,143 person-years of observation. During periods when influenzavirus was circulating, the average number of hospitalizations for cardiopulmonary conditions in excess of the expected number was 104 per 10,000 children per year for children younger than 6 months of age, 50 per 10,000 per year for those 6 months to less than 12 months, 19 per 10,000 per year for those 1 year to less than 3 years, 9 per 10,000 per year for those 3 years to less than 5 years, and 4 per 10,000 per year for those 5 years to less than 15 years. For every 100 children, an annual average of 6 to 15 outpatient visits and 3 to 9 courses of antibiotics were attributable to influenza. In winter, 10 to 30 percent of the excess number of courses of antibiotics occurred during periods when influenzavirus was circulating. Healthy children younger than one year of age are hospitalized for illness attributable to influenza at rates similar to those for adults at high risk for influenza. The rate of hospitalization decreases markedly with age. Influenza accounts for a substantial number of outpatient visits and courses of antibiotics in children of all ages.
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            Is Open Access

            Sex Differences in Pediatric Infectious Diseases

            Maximilian Muenchhoff, Philip Goulder (2014)
            The success of the immune response is finely balanced between, on the one hand, the need to engage vigorously with, and clear, certain pathogens; and, on the other, the requirement to minimize immunopathology and autoimmunity. Distinct immune strategies to achieve this balance have evolved in females and males and also in infancy through to adulthood. Sex differences in outcome from a range of infectious diseases can be identified from as early as fetal life, such as in congenital cytomegalovirus infection. The impact of sex hormones on the T-helper 1/T-helper 2 cytokine balance has been proposed to explain the higher severity of most infectious diseases in males. In the minority where greater morbidity and mortality is observed in females, this is hypothesized to arise because of greater immunopathology and/or autoimmunity. However, a number of unexplained exceptions to this rule are described. Studies that have actually measured the sex differences in children in the immune responses to infectious diseases and that would further test these hypotheses, are relatively scarce.
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              High morbidity and mortality in adults hospitalized for respiratory syncytial virus infections.

              Leon S-M Wong, Tonia Tse, Edward Chan … (2013)
              Better understanding of complications and outcomes of adults hospitalized with respiratory syncytial virus (RSV) infection is necessary. A retrospective cohort study was conducted on all adults (≥ 18 years) admitted to 3 acute care general hospitals in Hong Kong with virologically confirmed RSV infection during 2009-2011 (N = 607). Adults hospitalized for seasonal influenza during the period were used for comparison (n = 547). Both infections were prospectively diagnosed following a standard protocol. Independent reviews of chest radiographs were performed by radiologists. Main outcome measures were all-cause death, respiratory failure requiring ventilatory support, and hospitalization duration. Cox proportional hazards models were used for analyses. The mean age of RSV patients was 75 (SD, 16) years; 87% had underlying conditions. Lower respiratory and cardiovascular complications were diagnosed in 71.9% (pneumonia, 42.3%; acute bronchitis, 21.9%; chronic obstructive pulmonary disease/asthma exacerbation, 27.3%) and 14.3% of patients, respectively; 12.5% had bacterial superinfections. Supplemental oxygen and ventilatory support were required in 67.9% and 11.1%, respectively. Crude all-cause mortality was 9.1% and 11.9% within 30 days and 60 days, respectively; mean length of stay of survivors was 12 (SD, 13) days. Advanced age, radiographic pneumonia, requirement for ventilation, bacterial superinfection, and elevated urea level and white blood cell count were independently associated with poorer survival. Systemic corticosteroid use was associated with longer hospitalization and secondary infections. The overall outcomes of survival and length of stay were not significantly different from those in influenza. RSV can cause severe lower respiratory complications in older adults, resulting in respiratory failure, prolonged hospitalization, and high mortality similar to seasonal influenza. Corticosteroids did not seem to improve outcomes. The unmet need for antiviral therapy and vaccination against RSV in adults should be promptly addressed.
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                Author and article information

                Contributors
                Hans H. Hirsch:
                ORCID: http://orcid.org/0000-0003-0883-0423
                hans.hirsch@unibas.ch
                Journal
                Journal ID (nlm-ta): J Med Virol
                Journal ID (iso-abbrev): J. Med. Virol
                Journal ID (doi): 10.1002/(ISSN)1096-9071
                Journal ID (publisher-id): JMV
                Title: Journal of Medical Virology
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0146-6615
                ISSN (Electronic): 1096-9071
                Publication date (Electronic): 13 November 2018
                Publication date (Print): April 2019
                Volume: 91
                Issue: 4 ( doiID: 10.1002/jmv.v91.4 )
                Pages: 582-587
                Affiliations
                [ 1 ] Division of Infection Diagnostics, Department Biomedicine, Haus Petersplatz University of Basel Basel Switzerland
                [ 2 ] Transplantation and Clinical Virology, Department Biomedicine, Haus Petersplatz University of Basel Basel Switzerland
                [ 3 ] Infectious Diseases and Hospital Epidemiology University Hospital Basel Basel Switzerland
                Author notes
                [*] [* ] Correspondence Hans H. Hirsch, Transplantation and Clinical Virology, Department Biomedicine, Haus Petersplatz, University of Basel, Basel CH-4009, Switzerland. Email: hans.hirsch@ 123456unibas.ch

                Author information
                http://orcid.org/0000-0002-8440-8550
                http://orcid.org/0000-0003-0883-0423
                Article
                Publisher ID: JMV25344
                DOI: 10.1002/jmv.25344
                PMC ID: 7166997
                PubMed ID: 30345524
                SO-VID: 329f48c6-e5e4-49be-9c4b-11d15e8472da
                Copyright © © 2018 Wiley Periodicals, Inc.
                License:

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                Date received : 30 May 2018
                Date accepted : 13 October 2018
                Page count
                Figures: 1, Tables: 3, Pages: 6, Words: 3694
                Categories
                Subject: Research Article
                Subject: Research Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date April 2019
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.0 mode:remove_FC converted:15.04.2020

                ScienceOpen disciplines: Microbiology & Virology
                Keywords: influenza virus,nucleic acid amplification testing,point‐of‐care test,respiratory syncytial virus,turn‐around time
                Data availability:
                ScienceOpen disciplines: Microbiology & Virology
                Keywords: influenza virus, nucleic acid amplification testing, point‐of‐care test, respiratory syncytial virus, turn‐around time

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