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比较 Cepheid Xpert Xpress Flu/RSV 检测法和商业实时 PCR 在中国前瞻性队列中对甲型流感和乙型流感的检测。

Comparison of the Cepheid Xpert Xpress Flu/RSV assay and commercial real-time PCR for the detection of influenza A and influenza B in a prospective cohort from China.

机构信息

Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.

Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China.

出版信息

Int J Infect Dis. 2019 Mar;80:92-97. doi: 10.1016/j.ijid.2018.12.014. Epub 2019 Jan 8.

Abstract

BACKGROUND

The Xpert Xpress Flu/RSV assay is released by FDA for rapid detection of influenza A (FluA), influenza B (FluB), and respiratory syncytial virus (RSV). This study aimed to evaluate its clinical performance in comparison to that of the RT-PCR assay cleared by China FDA (CFDA-PCR).

METHODS

Nasopharyngeal specimens were collected from patients and tested by the two assays side by side. Discordant results were tested with a laboratory-developed real-time PCR for resolution. Viral load in the sample was quantified with a droplet digital PCR.

RESULTS

A total of 658 specimens were involved and gave 94.7%-99.1% agreement between the two assays. The Xpert assay showed higher sensitivity for FluA (100% vs. 89.8%) and FluB detection (100% vs. 95.3%), and also higher accuracy (98.9% vs. 95.7%) for FluA than the CDFA-PCR. The positive and negative predictive values (NPV) for the three viruses ranged from 90.5% to 100% in the two assays, with higher NPV for FluA and FluB in Xpert assay. Moreover, the Xpert Ct values showed a linear correlation with virus titer in specimens tested.

CONCLUSION

Overall, the Xpert assay is a reliable and sensitive tool for the detection of FluA, FluB and RSV in our clinical settings.

摘要

背景

Xpert Xpress Flu/RSV assay 经美国食品药品监督管理局(FDA)批准用于快速检测甲型流感(FluA)、乙型流感(FluB)和呼吸道合胞病毒(RSV)。本研究旨在评估其与中国食品药品监督管理局(CFDA-PCR)批准的 RT-PCR 检测相比的临床性能。

方法

采集患者的鼻咽拭子标本,同时用两种方法进行检测。对不一致的结果采用实验室开发的实时 PCR 检测进行解析。采用数字液滴 PCR 定量检测样本中的病毒载量。

结果

共涉及 658 份标本,两种方法的一致性为 94.7%-99.1%。Xpert 检测法对 FluA(100% vs. 89.8%)和 FluB 检测(100% vs. 95.3%)的敏感性更高,对 FluA 的准确性(98.9% vs. 95.7%)也更高。两种方法对三种病毒的阳性和阴性预测值(NPV)范围为 90.5%-100%,Xpert 检测法对 FluA 和 FluB 的 NPV 更高。此外,Xpert Ct 值与检测标本中的病毒滴度呈线性相关。

结论

总体而言,Xpert 检测法是一种可靠、敏感的工具,可用于我们临床环境中检测 FluA、FluB 和 RSV。

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