title: Near point-of-care administration by the attending physician of the rapid influenza antigen detection immunochromatography test and the fully automated respiratory virus nucleic acid test: contribution to patient management.
abstract: Rapid influenza antigen detection tests (RIADTs) using immunochromatography are the most readily available tools for the diagnosis and management of influenza. This study was designed to assess whether near point-of-care administration by primary care physicians of the RIADT and a fully automated respiratory virus nucleic acid test (Verigene Respiratory Virus Plus®; RV+) would contribute to improved patient management. When viral culture and RT-PCR/bi-directional sequencing were used as the gold standard, sensitivities and specificities for RIADT and RV+ were 58.3% and 90.9%, and 97.2% and 100%, respectively. Within 12 hours from onset of fever, sensitivities were 44.4% and 94.4%, respectively, for RIADT and RV+. In clinical situations where a higher-sensitivity test is needed, such as during pre-admission evaluations, for testing of hospital employees during the prodromal phase of infection, during the therapeutic decision-making process, and during outbreaks, we suggest that patients testing negative by the RIADT can be reassessed with the RV+ test to achieve maximal diagnostic accuracy.
authors.affiliation: Department of General Medicine, Juntendo University Nerima Hospital, Tokyo, Japan. sboku@juntendo.ac.jp
authors.forename: Soushin
authors.initials: S
authors.lastname: Boku
authors.forename: Toshio
authors.initials: T
authors.lastname: Naito
authors.forename: Kenji
authors.initials: K
authors.lastname: Murai
authors.forename: Mika
authors.initials: M
authors.lastname: Tanei
authors.forename: Akihiro
authors.initials: A
authors.lastname: Inui
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Nisimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Isonuma
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takahashi
authors.forename: Ken
authors.initials: K
authors.lastname: Kikuchi
mesh_terms: D000328:Adult; D002846:Chromatography, Affinity / Q000592:standards; D003937:Diagnosis, Differential; D003948:Diagnostic Techniques, Respiratory System / Q000592:standards*; D005260:Female; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification*; D009981:Influenza B virus / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis* / Q000821:virology; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000592:standards*; D019095:Point-of-Care Systems / Q000592:standards; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000302:isolation & purification; D012680:Sensitivity and Specificity
keywords: Fully automated respiratory virus Nucleic acid test; Influenza; Near point-of-care; Physician administered; Rapid influenza antigen detection Test by immunochromatography