TY - JOUR
T1 - Performance Assessment of a Rapid Molecular Respiratory Syncytial Virus Point-of-Care Test
T2 - A Prospective Community Study in Older Adults
AU - Zuurbier, Roy P
AU - Korsten, Koos
AU - Verheij, Theo J M
AU - Butler, Chris
AU - Adriaenssens, Niels
AU - Coenen, Samuel
AU - Gruselle, Olivier
AU - Vantomme, Valerie
AU - van Houten, Marlies A
AU - Bont, Louis J
AU - Wildenbeest, Joanne G
AU - REspiratory Syncytial virus Consortium in EUrope (RESCEU) Investigators
A2 - Fischer, Thea Kølsen
N1 - © The Author(s) 2022. Published by Oxford University Press for the Infectious Diseases Society of America.
PY - 2022/8/12
Y1 - 2022/8/12
N2 - BACKGROUND: Respiratory syncytial virus (RSV) causes a substantial burden in older adults. Viral load in RSV-infected adults is generally lower compared to young children, which could result in suboptimal sensitivity of RSV diagnostics. Although the Xpert® Xpress Flu/RSV assay has been used in routine clinical care, its sensitivity to diagnose RSV infection in older adults is largely unknown. We aimed to compare the performance of the Xpert® Xpress Flu/RSV assay with real-time reverse-transcription polymerase chain reaction (RT-PCR) in home-dwelling older adults (≥60 years of age).METHODS: Nasopharyngeal swabs were tested with Xpert® Xpress Flu/RSV and compared to RSV RT-PCR in older adults with acute respiratory tract infections with different levels of disease severity.RESULTS: We studied 758 respiratory samples from 561 older adults from 2 consecutive RSV seasons. Thirty-five (4.6%) samples tested positive for RSV by at least 1 of the assays, of which 2 samples were negative by Xpert® Xpress Flu/RSV and 3 samples by real-time RT-PCR. The positive percentage agreement (PPA) was 90.9% (95% confidence interval [CI], 76.4%-96.8%) and negative percentage agreement was 99.7% (95% CI, 99.0%-99.9%). Viral loads were low (≤103 copies/mL or cycle threshold value ≥34) in all cases with discordant results for the 2 assays.CONCLUSIONS: The PPA of Xpert® Xpress Flu/RSV compared to routine RT-PCR is high for RSV detection in home-dwelling older adults. The assay is fast and easy to use at the point of care.CLINICAL TRIALS REGISTRATION: NCT03621930.
AB - BACKGROUND: Respiratory syncytial virus (RSV) causes a substantial burden in older adults. Viral load in RSV-infected adults is generally lower compared to young children, which could result in suboptimal sensitivity of RSV diagnostics. Although the Xpert® Xpress Flu/RSV assay has been used in routine clinical care, its sensitivity to diagnose RSV infection in older adults is largely unknown. We aimed to compare the performance of the Xpert® Xpress Flu/RSV assay with real-time reverse-transcription polymerase chain reaction (RT-PCR) in home-dwelling older adults (≥60 years of age).METHODS: Nasopharyngeal swabs were tested with Xpert® Xpress Flu/RSV and compared to RSV RT-PCR in older adults with acute respiratory tract infections with different levels of disease severity.RESULTS: We studied 758 respiratory samples from 561 older adults from 2 consecutive RSV seasons. Thirty-five (4.6%) samples tested positive for RSV by at least 1 of the assays, of which 2 samples were negative by Xpert® Xpress Flu/RSV and 3 samples by real-time RT-PCR. The positive percentage agreement (PPA) was 90.9% (95% confidence interval [CI], 76.4%-96.8%) and negative percentage agreement was 99.7% (95% CI, 99.0%-99.9%). Viral loads were low (≤103 copies/mL or cycle threshold value ≥34) in all cases with discordant results for the 2 assays.CONCLUSIONS: The PPA of Xpert® Xpress Flu/RSV compared to routine RT-PCR is high for RSV detection in home-dwelling older adults. The assay is fast and easy to use at the point of care.CLINICAL TRIALS REGISTRATION: NCT03621930.
KW - diagnosis
KW - molecular
KW - older adults
KW - point-of-care test
KW - respiratory syncytial virus
UR - http://www.scopus.com/inward/record.url?scp=85136341842&partnerID=8YFLogxK
U2 - 10.1093/infdis/jiab600
DO - 10.1093/infdis/jiab600
M3 - Journal article
C2 - 35134954
SN - 0022-1899
VL - 226
SP - S63-S70
JO - The Journal of infectious diseases
JF - The Journal of infectious diseases
IS - Supplement_1
ER -