title: Clinical evaluation of NucliSENS magnetic extraction and NucliSENS analytical specific reagents for the real-time detection of respiratory syncytial virus (RSV) in paediatric respiratory specimens.
abstract: OBJECTIVE
  To evaluate the combination of NucliSENS magnetic extraction and NucliSENS analytical specific reagents (bioMérieux, Marcy L'Etoile, France) for the detection of respiratory syncytial virus (RSV) from a variety of respiratory samples.
  
  
  METHODS
  Nucleic acids (NA) from paediatric samples (n = 603) and an RSV-specific inhibition control (R-IC) were coextracted using the miniMAG and/or the easyMAG. Nucleic-acid-sequence-based amplification (NASBA) and molecular beacon detection of RSV and R-IC were performed using NucliSENS analyte-specific reagents (NRSVA) and the NucliSENS EasyQ Analyzer. NRSVA results were compared with R-Mix culture and direct fluorescent antibody detection (DFA).
  
  
  RESULTS
  The NRSVA analytical specificity was 100%, and the NRSVA limit of detection was 5-20 RNA copies/reaction. The prediscordant analysis, sensitivity, specificity, PPV and NPV were, respectively, for R-Mix (64.7%, 100%, 100%, 94.5%); DFA (98.8%, 99.0%, 94.4%, 99.8%); NRSVA (94.1%, 95%, 75.5%, 99%). After discordant analysis, sensitivity, specificity, PPV and NPV were, respectively, for R-Mix (56.7%, 100%, 100%, 92.3%); DFA (87.6%, 99.2%, 95.5%, 97.7%); NRSVA (93.8%, 97%, 85.9%, 99%). RSV was detected in 17.8% of the samples and in seven coinfections. Children with proven RSV infection, compared with children without a pathogen identified, had shorter median hospitalisation stays (2 days vs 3 days, p = 0.035), used fewer antibiotics (54% vs 69%) and had shorter durations of antibiotic therapy (6.2 days vs 9.3 days, p = 0.021), respectively.
  
  
  CONCLUSIONS
  NRSVA is sensitive and specific for RSV detection in respiratory samples. The R-IC monitored the test process, including NA extraction, target amplification and detection. The rapid detection of respiratory pathogens can foster appropriate patient management.
authors.affiliation: North Shore-Long Island Jewish Health System Laboratories, Department of Laboratory Medicine, Lake Success, New York 11042, USA.
authors.forename: R
authors.initials: R
authors.lastname: Manji
authors.forename: M
authors.initials: M
authors.lastname: Lotlikar
authors.forename: F
authors.initials: F
authors.lastname: Zhang
authors.forename: C C
authors.initials: CC
authors.lastname: Ginocchio
mesh_terms: D002675:Child, Preschool; D004812:Epidemiologic Methods; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008280:Magnetics; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D012367:RNA, Viral / Q000032:analysis / Q000302:isolation & purification; D011933:Reagent Kits, Diagnostic; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis*; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000175:diagnosis*
chemical_list: D012367:RNA, Viral; D011933:Reagent Kits, Diagnostic