[Comparison study of a real-time reverse transcription polymerase chain reaction assay with an enzyme immunoassay and shell vial culture for influenza A and B virus detection in adult patients].
BACKGROUND
The age of the patients and the type of sample are major problems in the diagnosis of influenza. Most available diagnostic techniques are highly effective in pediatric patients and in nasopharyngeal aspirates. However, in the adult population and using throat swabs, these techniques are much less reliable.


OBJECTIVE
We performed a prospective study comparing the efficacy of a commercial real-time reverse transcription PCR assay (RT-PCR) with that of an enzyme immunoassay (EIA) or shell vial culture (SV) in the detection of influenza A and B viruses in 125 throat swabs from adults with clinically suspected influenza during the 2007-2008 flu season.


METHODS
Throat swabs were subjected to rapid antigen detection for influenza viruses by means of a commercial dot-blot EIA. For the RT-PCR technique, RNA was extracted from 200 microL of each sample by the automated extraction system, EZ1 virus minikit (version 2.0). Genomic amplification of the extracted viral RNA was carried out using the OneStep RT-PCR FluA+FluB automated system with the SmartCycler amplification system. Each sample was inoculated into 2 SV of the MDCK cell line. Turnaround times were calculated from the time specimens were received in the laboratory to the time the result was reported to clinicians.


RESULTS
The EIA system detected 27 (21.6%) positive samples, RT-PCR 62 (49.6%) positive samples, and SV 56 (44.8%) positive samples. Among the 62 positive samples, EIA detected 27 (43.5%), RT-PCR 62 (100%) and SV 56 (90.3%). With the use of RT-PCR, 38.4% of the adults studied were diagnosed on the same day samples were received. Among the total, 67.2% of diagnostic results were obtained within the first 24 hours; turnaround time was 1.1 days.


CONCLUSIONS
The real-time RT-PCR method studied displayed high sensitivity and specificity in the detection of influenza virus in adult patients, when compared with the conventional techniques. With real-time RT-PCR, large numbers of samples can be rapidly tested and results provided the same day samples are received.
Reina
Jordi
J
Unidad de Virología, Servicio de Microbiología, Hospital Universitario Son Dureta, Mallorca, Spain. jorge.reina@ssib.es
Plasencia
Virginia
V
Leyes
Maria
M
Nicolau
Antonio
A
Galmés
Antonia
A
Arbona
Gabriel
G
D000328:Adult; D000818:Animals; D000956:Antigens, Viral / Q000032:analysis*; D002460:Cell Line / Q000821:virology; D003199:Computer Systems; D004285:Dogs; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007124:Immunoenzyme Techniques; D009980:Influenza A virus / Q000235:genetics / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification*; D009981:Influenza B virus / Q000235:genetics / Q000254:growth & development / Q000276:immunology / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D010614:Pharynx / Q000821:virology*; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D014766:Viremia / Q000175:diagnosis / Q000276:immunology / Q000821:virology*; D014776:Virus Cultivation / Q000295:instrumentation
D000956:Antigens, Viral; D012367:RNA, Viral