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新型Alere™ i甲型和乙型流感等温核酸扩增检测的多中心临床评估

Multicenter clinical evaluation of the novel Alere™ i Influenza A&B isothermal nucleic acid amplification test.

作者信息

Bell Jeremiah, Bonner Aleta, Cohen Daniel M, Birkhahn Robert, Yogev Ram, Triner Wayne, Cohen Jason, Palavecino Elizabeth, Selvarangan Rangaraj

机构信息

Children's Mercy Hospitals and Clinics, Kansas City, MO, United States; University of Missouri Kansas City School of Medicine, Kansas City, MO, United States.

Veritas, P.A., Belton, TX, United States.

出版信息

J Clin Virol. 2014 Sep;61(1):81-6. doi: 10.1016/j.jcv.2014.06.001. Epub 2014 Jun 7.

Abstract

BACKGROUND

Rapid detection of influenza infection is important for patient management and timely anti-viral therapy. Rapid antigen detection tests for influenza have inferior sensitivity when compared to nucleic acid-based amplification tests. An isothermal nucleic acid amplification test that offers the potential for rapid molecular testing at the clinical point-of-care with simple equipment can improve influenza detection rates.

OBJECTIVES

To evaluate the performance of Alere™ i Influenza A&B isothermal nucleic acid amplification test to detect influenza A and B in comparison to viral cell culture as reference method.

STUDY DESIGN

A prospective, multicenter, clinical study to evaluate the clinical performance of the Alere™ i Influenza A&B assay in a point-of-care setting using prospectively enrolled specimens from both children and adults was conducted in seven sites.

RESULTS

In comparison with viral cell culture, the overall sensitivity and specificity of the Alere™ i Influenza A&B assay was 97.8% and 85.6% for the detection of influenza A, and 91.8% and 96.3% for the detection of influenza B, respectively. Following resolution of discrepant results by real-time RT-PCR the sensitivity and specificity of the Alere™ i Influenza A&B assay improved to 99.3% and 98.1% for influenza A, and 97.6% and 100% for influenza B, respectively.

CONCLUSIONS

The Alere™ i Influenza A&B isothermal nucleic acid amplification test is an ideal point-of-care test for influenza detection in children and adults due to its high sensitivity and specificity and ability to generate results within 15 min from specimen receipt.

摘要

背景

快速检测流感感染对于患者管理和及时进行抗病毒治疗至关重要。与基于核酸的扩增检测相比,流感快速抗原检测试验的敏感性较差。一种等温核酸扩增检测方法,有望在临床护理点使用简单设备进行快速分子检测,可提高流感检测率。

目的

与作为参考方法的病毒细胞培养相比,评估Alere™ i甲型和乙型流感等温核酸扩增检测方法检测甲型和乙型流感的性能。

研究设计

在七个地点开展了一项前瞻性、多中心临床研究,以评估Alere™ i甲型和乙型流感检测方法在临床护理点环境中的临床表现,该研究使用了来自儿童和成人的前瞻性入组标本。

结果

与病毒细胞培养相比,Alere™ i甲型和乙型流感检测方法检测甲型流感的总体敏感性和特异性分别为97.8%和85.6%,检测乙型流感的总体敏感性和特异性分别为91.8%和96.3%。通过实时逆转录聚合酶链反应解决不一致结果后,Alere™ i甲型和乙型流感检测方法检测甲型流感的敏感性和特异性分别提高到99.3%和98.1%,检测乙型流感的敏感性和特异性分别提高到97.6%和100%。

结论

Alere™ i甲型和乙型流感等温核酸扩增检测方法具有高敏感性和特异性,且能在收到标本后15分钟内得出结果,是检测儿童和成人流感的理想床旁检测方法。

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