Department of Paediatrics, Division of Pneumonology-Immunology, Charité University Medical Centre, Augustenburger Platz 1, Berlin, Germany.
J Clin Virol. 2012 Dec;55(4):329-33. doi: 10.1016/j.jcv.2012.08.002. Epub 2012 Aug 24.
The appropriate management of infants and children with influenza depends on the accurate and timely diagnosis, ideally at the point of care (POC).
To evaluate the use of simultaneous RSV/influenza rapid testing with QuickVue™ test strips as well as (the use of) novel, fluorescence-based, rapid influenza antigen testing (SOFIA™) in infants and children with influenza-like illness (ILI).
The Study was conducted in a real-time surveillance program at the Charité Department of Pediatrics in collaboration with the National Reference Centre for Influenza at the Robert Koch Institute (RKI) in Berlin, Germany (Charité Influenza-Like Disease=ChILD Cohort).
During the 2010/2011 influenza season, 395 infants and children were simultaneously tested using QuickVue™ FluA&B and RSV10 rapid tests at POC compared to independent RT-PCR. Sensitivities were 62.7/67.8% for Influenza/RSV overall, but highest in infants <1 year with 76.0/76.2%. The evaluation of the fluorescence-based rapid test SOFIA™ with frozen laboratory samples (derived from the 2008/2009 and 2010/2011 national surveillance) yielded sensitivities of 97.7/86.7/86.7/81.7% for influenza A(H1N1)pdm09/A(H3N2)/B-Victoria/B-Yamagata in samples with CT values <34, and 80.2/79.8/67.5/62.5% for all CT values combined. The same method used at POC with 649 consecutive ChILD patients in 2011-2012 yielded sensitivity/specificity/PPV/NPV values of 78.9/99.7/96.6/97.3%. Again, sensitivities were highest in infants (85.7%) and small children <2 years (88%).
Fluorescence-based rapid antigen testing provides a highly sensitive and specific tool for POC diagnostics of acute influenza in the paediatric age group, especially in infants and small children <2 years, when viral loads are at their peak and treatment decisions are imminent.
对流感患儿的适当处理取决于准确、及时的诊断，理想情况下应在护理点（POC）进行。
评估同时使用 QuickVue™ 测试条进行 RSV/流感快速检测，以及使用新型荧光快速流感抗原检测（SOFIA™）在流感样疾病（ILI）患儿中的应用。
该研究在德国柏林 Charité 儿科部门与国家流感参考中心（罗伯特·科赫研究所，RKI）合作开展的实时监测项目中进行（Charité 流感样疾病=儿童队列）。
在 2010/2011 流感季节，395 名婴儿和儿童在 POC 同时使用 QuickVue™ FluA&B 和 RSV10 快速检测进行检测，与独立的 RT-PCR 相比。流感/RSV 的总体敏感性为 62.7/67.8%，但 1 岁以下婴儿的敏感性最高，为 76.0/76.2%。使用冷冻实验室样本（源自 2008/2009 年和 2010/2011 年全国监测）评估基于荧光的快速检测 SOFIA™，在 CT 值<34 的样本中，流感 A(H1N1)pdm09/A(H3N2)/B-Victoria/B-Yamagata 的敏感性分别为 97.7/86.7/86.7/81.7%，所有 CT 值的综合敏感性为 80.2/79.8/67.5/62.5%。在 2011-2012 年，使用同一方法对 649 例连续的 ChILD 患者进行检测，敏感性/特异性/PPV/NPV 值分别为 78.9/99.7/96.6/97.3%。同样，敏感性在婴儿（85.7%）和<2 岁的幼儿（88%）中最高。
基于荧光的快速抗原检测为儿科年龄组急性流感的 POC 诊断提供了一种高度敏感和特异的工具，特别是在病毒载量达到峰值且治疗决策迫在眉睫的婴儿和<2 岁的幼儿中。
