title: Rapid identification of respiratory syncytial virus infections by direct fluorescent antibody testing: reliability as a guide to patient cohorting.
abstract: This study compared the results of a commercially available, direct fluorescent antibody (DFA) test with viral culture in 880 specimens obtained from 690 patients by means of nasopharyngeal swabs. The two tests were congruent in 92.5% (814) of the specimens. The sensitivity of the DFA was 0.95, the specificity was 0.91, the positive predictive value was 0.82, and the negative predictive value was 0.98. Among 548 inpatients, there were 3 mixed infections (RSV and another virus), 8 RSV infections not identified by the DFA, and 35 positive DFA results not confirmed by cell culture. Use of the DFA test alone would have resulted in 502 (92%) correct patient-placement decisions. We conclude that the DFA test provides reliable evidence on which to base patient-placement decisions but that the error rate is too high to permit safe cohorting of high-risk patients, such as those with bronchopulmonary dysplasia.
authors.affiliation: Department of Infection Control, Minneapolis Children's Medical Center, MN 55404.
authors.forename: D
authors.initials: D
authors.lastname: Jacobsen
authors.forename: P
authors.initials: P
authors.lastname: Ackerman
authors.forename: N R
authors.initials: NR
authors.lastname: Payne
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005455:Fluorescent Antibody Technique; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008910:Minnesota; D011237:Predictive Value of Tests; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification*; D010253:Respirovirus Infections / Q000453:epidemiology / Q000382:microbiology*