title: Rapid antigen detection test for respiratory syncytial virus diagnosis as a diagnostic tool.
abstract: OBJECTIVE
  The aim of this study was to evaluate the QuickVue®RSV Test Kit (QUIDEL Corp, CA, USA) as a screening tool for respiratory syncytial virus in children with acute respiratory disease in comparison with the indirect immunofluorescence assay as gold standard. In Brazil, rapid antigen detection tests for respiratory syncytial virus are not routinely utilized as a diagnostic tool, except for the diagnosis of dengue and influenza.
  
  
  METHODS
  The authors retrospectively analyzed 486 nasopharyngeal aspirate samples from children under age 5 with acute respiratory infection, between December 2013 and August 2014, the samples were analyzed by indirect immunofluorescence assay and QuickVue®RSV Test kit. Samples with discordant results were analyzed by real time PCR and nucleotide sequencing.
  
  
  RESULTS
  From 313 positive samples by immunofluorescence assays, 282 (90%) were also positive by the rapid antigen detection test, two were positive only by rapid antigen detection test, 33 were positive only by immunofluorescence assays, and 171 were positive by both methods. The 35 samples with discordant results were analyzed by real time PCR; the two samples positive only by rapid antigen detection test and the five positive only by immunofluorescence assays were also positive by real time PCR. There was no relation between the negativity by QuickVue®RSV Test and viral load or specific strain. The QuickVue®RSV Test showed sensitivity of 90%, specificity of 98.8%, predictive positive value of 99.3%, and negative predictive value of 94.6%, with accuracy of 93.2% and agreement κ index of 0.85 in comparison to immunofluorescence assay.
  
  
  CONCLUSIONS
  This study demonstrated that the QuickVue®RSV Test Kit can be effective in early detection of Respiratory syncytial virus in nasopharyngeal aspirate and is reliable for use as a diagnostic tool in pediatrics.
authors.affiliation: Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil.
authors.forename: Flávio da Silva
authors.initials: FDS
authors.lastname: Mesquita
authors.affiliation: Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil. Electronic address: danibruna@gmail.com.
authors.forename: Danielle Bruna Leal de
authors.initials: DBL
authors.lastname: Oliveira
authors.affiliation: Universidade de São Paulo, Hospital Universitário, Laboratório Clínico, São Paulo, SP, Brazil.
authors.forename: Daniela
authors.initials: D
authors.lastname: Crema
authors.affiliation: Universidade de São Paulo, Hospital Universitário, Laboratório Clínico, São Paulo, SP, Brazil.
authors.forename: Célia Miranda Nunes
authors.initials: CMN
authors.lastname: Pinez
authors.affiliation: Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil.
authors.forename: Thaís Cristina
authors.initials: TC
authors.lastname: Colmanetti
authors.affiliation: Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil.
authors.forename: Luciano Matsumia
authors.initials: LM
authors.lastname: Thomazelli
authors.affiliation: Universidade de São Paulo, Hospital Universitário, Divisão de Pediatria, São Paulo, SP, Brazil.
authors.forename: Alfredo Elias
authors.initials: AE
authors.lastname: Gilio
authors.affiliation: Universidade de São Paulo, Hospital Universitário, Divisão de Pediatria, São Paulo, SP, Brazil.
authors.forename: Sandra Elisabeth
authors.initials: SE
authors.lastname: Vieira
authors.affiliation: Universidade de São Paulo, Hospital Universitário, Laboratório Clínico, São Paulo, SP, Brazil; Universidade de São Paulo, Escola de Ciências Farmacêuticas, São Paulo, SP, Brazil.
authors.forename: Marina Baquerizo
authors.initials: MB
authors.lastname: Martinez
authors.affiliation: Instituto Butantan, Laboratório de Virologia, Divisão de Desenvolvimento Científico, São Paulo, SP, Brazil.
authors.forename: Viviane Fongaro
authors.initials: VF
authors.lastname: Botosso
authors.affiliation: Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil.
authors.forename: Edison Luiz
authors.initials: EL
authors.lastname: Durigon
mesh_terms: D000956:Antigens, Viral / Q000032:analysis*; D001938:Brazil; D002675:Child, Preschool; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008297:Male; D011933:Reagent Kits, Diagnostic; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000821:virology; D012136:Respiratory Syncytial Viruses / Q000276:immunology* / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000821:virology; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
chemical_list: D000956:Antigens, Viral; D011933:Reagent Kits, Diagnostic
keywords: Rapid antigen detection test – RADT; Respiratory syncytial virus – RSV; Respiratory viruses; Teste Rápido de Detecção de Antígeno – TRDA; Viroses Respiratórias; Virus Sincicial Respiratório – VSR