Low Sensitivity of BinaxNOW RSV in Infants

Roy P Zuurbier; Louis J Bont; Annefleur C Langedijk; Mirjam Hamer; Koos Korsten; Simon B Drysdale; Matthew D Snape; Hannah Robinson; Andrew J Pollard; Federico Martinón-Torres; Carmen Rodríguez-Tenreiro Sánchez; Alberto Gómez-Carballa; Ana Isabel Dacosta-Urbieta; Terho Heikkinen; Steve Cunningham; Marlies A van Houten; Joanne G Wildenbeest; RESCEU Investigators; Thea Kølsen Fischer

doi:10.1093/infdis/jiaa050

Low Sensitivity of BinaxNOW RSV in Infants

Roy P Zuurbier, Louis J Bont, Annefleur C Langedijk, Mirjam Hamer, Koos Korsten, Simon B Drysdale, Matthew D Snape, Hannah Robinson, Andrew J Pollard, Federico Martinón-Torres, Carmen Rodríguez-Tenreiro Sánchez, Alberto Gómez-Carballa, Ana Isabel Dacosta-Urbieta, Terho Heikkinen, Steve Cunningham, Marlies A van Houten, Joanne G Wildenbeest, RESCEU Investigators , Thea Kølsen Fischer (Member of author group)

11 Citations (Scopus)

Abstract

BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. Early detection of RSV can optimize clinical management and minimize use of antibiotics. BinaxNOW RSV (BN) is a rapid antigen detection test that is widely used. We aimed to validate the sensitivity of BN in hospitalized and nonhospitalized infants against the gold standard of molecular diagnosis.

METHODS: We evaluated the performance of BN in infants with acute respiratory tract infections with different degrees of disease severity. Diagnostic accuracy of BN test results were compared with molecular diagnosis as reference standard.

RESULTS: One hundred sixty-two respiratory samples from 148 children from October 2017 to February 2019 were studied. Sixty-six (40.7%) samples tested positive for RSV (30 hospitalizations, 31 medically attended episodes not requiring hospitalization, and 5 nonmedically attended episodes). Five of these samples tested positive with BN, leading to an overall sensitivity of BN of 7.6% (95% confidence interval [CI], 3.3%-16.5%) and a specificity of 100% (95% CI, 96.2%-100%). Sensitivity was low in all subgroups.

CONCLUSIONS: We found a low sensitivity of BN for point-of-care detection of RSV infection. BinaxNOW RSV should be used and interpreted with caution.

Original language	English
Journal	The Journal of infectious diseases
Volume	222
Issue number	Suppl 7
Pages (from-to)	S640-S647
ISSN	0022-1899
DOIs	https://doi.org/10.1093/infdis/jiaa050
Publication status	Published - 7 Oct 2020
Externally published	Yes

Keywords

Adolescent
Antigens, Viral/blood
Case-Control Studies
Child
Child, Preschool
Cohort Studies
Female
Hospitalization/statistics & numerical data
Humans
Male
Pathology, Molecular/methods
Point-of-Care Systems
Reagent Kits, Diagnostic
Respiratory Syncytial Virus Infections/diagnosis
Respiratory Syncytial Virus, Human/isolation & purification
Sensitivity and Specificity

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10.1093/infdis/jiaa050

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Zuurbier, R. P., Bont, L. J., Langedijk, A. C., Hamer, M., Korsten, K., Drysdale, S. B., Snape, M. D., Robinson, H., Pollard, A. J., Martinón-Torres, F., Rodríguez-Tenreiro Sánchez, C., Gómez-Carballa, A., Dacosta-Urbieta, A. I., Heikkinen, T., Cunningham, S., van Houten, M. A., Wildenbeest, J. G., RESCEU Investigators , & Fischer, T. K. (2020). Low Sensitivity of BinaxNOW RSV in Infants. The Journal of infectious diseases, 222(Suppl 7), S640-S647. https://doi.org/10.1093/infdis/jiaa050

Zuurbier, RP, Bont, LJ, Langedijk, AC, Hamer, M, Korsten, K, Drysdale, SB, Snape, MD, Robinson, H, Pollard, AJ, Martinón-Torres, F, Rodríguez-Tenreiro Sánchez, C, Gómez-Carballa, A, Dacosta-Urbieta, AI, Heikkinen, T, Cunningham, S, van Houten, MA, Wildenbeest, JG, RESCEU Investigators & Fischer, TK 2020, 'Low Sensitivity of BinaxNOW RSV in Infants', The Journal of infectious diseases, vol. 222, no. Suppl 7, pp. S640-S647. https://doi.org/10.1093/infdis/jiaa050

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title = "Low Sensitivity of BinaxNOW RSV in Infants",

abstract = "BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. Early detection of RSV can optimize clinical management and minimize use of antibiotics. BinaxNOW RSV (BN) is a rapid antigen detection test that is widely used. We aimed to validate the sensitivity of BN in hospitalized and nonhospitalized infants against the gold standard of molecular diagnosis.METHODS: We evaluated the performance of BN in infants with acute respiratory tract infections with different degrees of disease severity. Diagnostic accuracy of BN test results were compared with molecular diagnosis as reference standard.RESULTS: One hundred sixty-two respiratory samples from 148 children from October 2017 to February 2019 were studied. Sixty-six (40.7\%) samples tested positive for RSV (30 hospitalizations, 31 medically attended episodes not requiring hospitalization, and 5 nonmedically attended episodes). Five of these samples tested positive with BN, leading to an overall sensitivity of BN of 7.6\% (95\% confidence interval [CI], 3.3\%-16.5\%) and a specificity of 100\% (95\% CI, 96.2\%-100\%). Sensitivity was low in all subgroups.CONCLUSIONS: We found a low sensitivity of BN for point-of-care detection of RSV infection. BinaxNOW RSV should be used and interpreted with caution.",

keywords = "Adolescent, Antigens, Viral/blood, Case-Control Studies, Child, Child, Preschool, Cohort Studies, Female, Hospitalization/statistics \& numerical data, Humans, Male, Pathology, Molecular/methods, Point-of-Care Systems, Reagent Kits, Diagnostic, Respiratory Syncytial Virus Infections/diagnosis, Respiratory Syncytial Virus, Human/isolation \& purification, Sensitivity and Specificity",

author = "Zuurbier, \{Roy P\} and Bont, \{Louis J\} and Langedijk, \{Annefleur C\} and Mirjam Hamer and Koos Korsten and Drysdale, \{Simon B\} and Snape, \{Matthew D\} and Hannah Robinson and Pollard, \{Andrew J\} and Federico Martin{\'o}n-Torres and \{Rodr{\'i}guez-Tenreiro S{\'a}nchez\}, Carmen and Alberto G{\'o}mez-Carballa and Dacosta-Urbieta, \{Ana Isabel\} and Terho Heikkinen and Steve Cunningham and \{van Houten\}, \{Marlies A\} and Wildenbeest, \{Joanne G\} and \{RESCEU Investigators\} and Fischer, \{Thea K{\o}lsen\}",

year = "2020",

month = oct,

day = "7",

doi = "10.1093/infdis/jiaa050",

language = "English",

volume = "222",

pages = "S640--S647",

journal = "The Journal of infectious diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "Suppl 7",

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TY - JOUR

T1 - Low Sensitivity of BinaxNOW RSV in Infants

AU - Zuurbier, Roy P

AU - Bont, Louis J

AU - Langedijk, Annefleur C

AU - Hamer, Mirjam

AU - Korsten, Koos

AU - Drysdale, Simon B

AU - Snape, Matthew D

AU - Robinson, Hannah

AU - Pollard, Andrew J

AU - Martinón-Torres, Federico

AU - Rodríguez-Tenreiro Sánchez, Carmen

AU - Gómez-Carballa, Alberto

AU - Dacosta-Urbieta, Ana Isabel

AU - Heikkinen, Terho

AU - Cunningham, Steve

AU - van Houten, Marlies A

AU - Wildenbeest, Joanne G

AU - RESCEU Investigators

A2 - Fischer, Thea Kølsen

PY - 2020/10/7

Y1 - 2020/10/7

N2 - BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. Early detection of RSV can optimize clinical management and minimize use of antibiotics. BinaxNOW RSV (BN) is a rapid antigen detection test that is widely used. We aimed to validate the sensitivity of BN in hospitalized and nonhospitalized infants against the gold standard of molecular diagnosis.METHODS: We evaluated the performance of BN in infants with acute respiratory tract infections with different degrees of disease severity. Diagnostic accuracy of BN test results were compared with molecular diagnosis as reference standard.RESULTS: One hundred sixty-two respiratory samples from 148 children from October 2017 to February 2019 were studied. Sixty-six (40.7%) samples tested positive for RSV (30 hospitalizations, 31 medically attended episodes not requiring hospitalization, and 5 nonmedically attended episodes). Five of these samples tested positive with BN, leading to an overall sensitivity of BN of 7.6% (95% confidence interval [CI], 3.3%-16.5%) and a specificity of 100% (95% CI, 96.2%-100%). Sensitivity was low in all subgroups.CONCLUSIONS: We found a low sensitivity of BN for point-of-care detection of RSV infection. BinaxNOW RSV should be used and interpreted with caution.

AB - BACKGROUND: Respiratory syncytial virus (RSV) is a major cause of hospitalization in infants. Early detection of RSV can optimize clinical management and minimize use of antibiotics. BinaxNOW RSV (BN) is a rapid antigen detection test that is widely used. We aimed to validate the sensitivity of BN in hospitalized and nonhospitalized infants against the gold standard of molecular diagnosis.METHODS: We evaluated the performance of BN in infants with acute respiratory tract infections with different degrees of disease severity. Diagnostic accuracy of BN test results were compared with molecular diagnosis as reference standard.RESULTS: One hundred sixty-two respiratory samples from 148 children from October 2017 to February 2019 were studied. Sixty-six (40.7%) samples tested positive for RSV (30 hospitalizations, 31 medically attended episodes not requiring hospitalization, and 5 nonmedically attended episodes). Five of these samples tested positive with BN, leading to an overall sensitivity of BN of 7.6% (95% confidence interval [CI], 3.3%-16.5%) and a specificity of 100% (95% CI, 96.2%-100%). Sensitivity was low in all subgroups.CONCLUSIONS: We found a low sensitivity of BN for point-of-care detection of RSV infection. BinaxNOW RSV should be used and interpreted with caution.

KW - Adolescent

KW - Antigens, Viral/blood

KW - Case-Control Studies

KW - Child

KW - Child, Preschool

KW - Cohort Studies

KW - Female

KW - Hospitalization/statistics & numerical data

KW - Humans

KW - Male

KW - Pathology, Molecular/methods

KW - Point-of-Care Systems

KW - Reagent Kits, Diagnostic

KW - Respiratory Syncytial Virus Infections/diagnosis

KW - Respiratory Syncytial Virus, Human/isolation & purification

KW - Sensitivity and Specificity

UR - https://www.scopus.com/pages/publications/85086440254

U2 - 10.1093/infdis/jiaa050

DO - 10.1093/infdis/jiaa050

M3 - Journal article

C2 - 32227106

SN - 0022-1899

VL - 222

SP - S640-S647

JO - The Journal of infectious diseases

JF - The Journal of infectious diseases

IS - Suppl 7

ER -

Low Sensitivity of BinaxNOW RSV in Infants

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