title: Comparison of the direct fluorescence assay and real-time polymerase chain reaction for the detection of influenza virus A and B in immunocompromised patients.
abstract: OBJECTIVE
  This study evaluated the diagnostic performance of two methods for the detection of influenza virus in immunocompromised transplant patients.
  
  
  METHODS
  A total of 475 respiratory samples, 236 from patients in a hematopoietic stem cell transplantation program and 239 from kidney transplant patients, were analyzed by a direct fluorescence assay and the Centers for Disease Control real-time polymerase chain reaction protocol for influenza A and B detection.
  
  
  RESULTS
  Influenza detection using either method was 7.6% in the hematopoietic stem cell transplant group and 30.5% in the kidney transplant patient group. Influenza detection by real-time polymerase chain reaction yielded a higher positive rate compared with fluorescence than that reported by other studies, and this difference was more pronounced for influenza A. The fluorescence assay sensitivity, specificity, positive and negative predictive values, and kappa coefficient were 17.6%, 100%, 1, 0.83, and 0.256, respectively, and lower detection rates occurred in the kidney transplant patients.
  
  
  CONCLUSIONS
  The real-time polymerase chain reaction performance and the associated turnaround time for a large number of samples support the choice of this method for use in different routine diagnostic settings and influenza surveillance in high-risk patients.
authors.affiliation: Clinical Virology Laboratory, Infections Disease Unit, Medicine Department, Federal University of São Paulo, São PauloSP, Brazil.
authors.forename: Ana Helena
authors.initials: AH
authors.lastname: Perosa
authors.forename: Aripuanã S A
authors.initials: AS
authors.lastname: Watanabe
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Guatura
authors.forename: Ellen R M
authors.initials: ER
authors.lastname: Silva
authors.forename: Celso
authors.initials: C
authors.lastname: Granato
authors.forename: Nancy
authors.initials: N
authors.lastname: Bellei
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D019085:Fluorescent Antibody Technique, Direct; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D009980:Influenza A virus / Q000276:immunology / Q000302:isolation & purification*; D009981:Influenza B virus / Q000276:immunology / Q000302:isolation & purification*; D007251:Influenza, Human / Q000175:diagnosis* / Q000276:immunology; D016030:Kidney Transplantation; D016015:Logistic Models; D008875:Middle Aged; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult