Bosevska Golubinka, Panovski Nikola, Janceska Elizabeta, Mikik Vladimir, Topuzovska Irena Kondova, Milenkovik Zvonko
Institute of Public Health
Institute of Microbiology and Parasitology, Medical Faculty, Sts. Cyril and Methodius University
Folia Med (Plovdiv). 2015 Apr-Jun;57(2):104-10. doi: 10.1515/folmed-2015-0027.
Early diagnosis and treatment of patients with influenza is the reason why physicians need rapid high-sensitivity influenza diagnostic tests that require no complex lab equipment and can be performed and interpreted within 15 min. The Aim of this study was to compare the rapid Directigen Flu A+B test with real time PCR for detection of influenza viruses in the Republic of Macedonia.
One-hundred-eight respiratory samples (combined nose and throat swabs) were routinely collected for detection of influenza virus during influenza seasons. Forty-one patients were pediatric cases and 59 were adult. Their mean age was 23 years. The patients were allocated into 6 age groups: 0-4 yrs, 5-9 yrs, 10-14 yrs, 15-19 yrs, 20-64 yrs and > 65 yrs. Each sample was tested with Directigen Flu A+B and CDC real time PCR kit for detection and typisation/subtypisation of influenza according to the lab diagnostic protocol.
Directigen Flu A+B identified influenza A virus in 20 (18.5%) samples and influenza B virus in two 2 (1.9%) samples. The high specificity (100%) and PPV of Directigen Flu A+B we found in our study shows that the positive results do not need to be confirmed. The overall sensitivity of Directigen Flu A+B is 35.1% for influenza A virus and 33.0% for influenza B virus. The sensitivity for influenza A is higher among children hospitalized (45.0%) and outpatients (40.0%) versus adults.
Directigen Flu A+B has relatively low sensitivity for detection of influenza viruses in combined nose and throat swabs. Negative results must be confirmed.
对流感患者进行早期诊断和治疗是医生需要快速、高灵敏度流感诊断测试的原因,这类测试无需复杂的实验室设备,且能在15分钟内完成检测和结果解读。本研究的目的是比较快速流感A+B直接检测试验与实时聚合酶链反应(PCR)在马其顿共和国检测流感病毒的效果。
在流感季节,常规采集108份呼吸道样本(鼻拭子和咽拭子联合样本)用于检测流感病毒。其中41例为儿科病例,59例为成人病例。他们的平均年龄为23岁。患者被分为6个年龄组:0 - 4岁、5 - 9岁、10 - 14岁、15 - 19岁、20 - 64岁和>65岁。根据实验室诊断方案,每个样本分别用流感A+B直接检测试验和美国疾病控制与预防中心(CDC)实时PCR试剂盒进行检测,以确定流感病毒的类型/亚型。
流感A+B直接检测试验在20份(18.5%)样本中检测出甲型流感病毒,在2份(1.9%)样本中检测出乙型流感病毒。我们在研究中发现流感A+B直接检测试验具有高特异性(100%)和阳性预测值,这表明阳性结果无需进一步确认。流感A+B直接检测试验对甲型流感病毒的总体灵敏度为35.1%,对乙型流感病毒的总体灵敏度为33.0%。与成人相比,住院儿童(45.0%)和门诊儿童(40.0%)中甲型流感的检测灵敏度更高。
流感A+B直接检测试验在检测鼻拭子和咽拭子联合样本中的流感病毒时灵敏度相对较低。阴性结果必须进行确认。