Velasco John Mark, Valderama Maria Theresa, Diones Paula Corazon, Navarro Fatima Claire, Develos Maribel, Lopez Ma Nila, Liao Cynthia, Chua Domingo, Macareo Louis, Fernandez Stefan
Department of Virology, U.S. Army Medical Directorate-Armed Forces Research Institute of Medical Sciences, Bangkok, 10400, Thailand.
University of the Philippines Manila, Ermita, Manila, 1000, Philippines.
Mil Med. 2022 Jan 4;187(1-2):e197-e200. doi: 10.1093/milmed/usab006.
It is important to evaluate the performance of existing rapid influenza diagnostic tests (RIDTs) and the factors that can affect performance especially when the circulation dynamics of influenza strains change such as the displacement and replacement of the circulating seasonal influenza strains.
Nasal swabs were collected from patients presenting at V Luna Medical Center, Armed Forces of the Philippines Health Service Command, with influenza-like illness (ILI) with one swab tested using Quickvue (QV) influenza A+B RIDT (Quidel) and the other swab tested using the ABI 7500 (Applied Biosystems) real-time reverse transcriptase-polymerase chain reaction. Sensitivity, specificity, positive predictive value, and negative predictive value were estimated. We identified clinical symptoms predictive of influenza subtype and evaluated the independence of QV sensitivity on (1) Cycle threshold (Ct) value, controlling for timing of collection; (2) timing of collection, controlling for Ct value; and (3) Ct value and timing of collection taken together.
Between August 2011 and October 2016, patients presenting with ILI (n = 2333) underwent testing. Quickvue sensitivity across all subtypes was significantly correlated with lower Ct values (higher virus titers) (P <.001) and, except for flu A/H3 (P = .974), was also significantly associated with timing of specimen collection (P <.05). No statistically significant difference was noted in QV sensitivity for Flu A/H3 (P = .130), pandemic H1/N1 (P = .207), Flu A/H3 + pandemic H1/N1 (P = .341), and Flu B (P = .103) across different age groups but sensitivity of QV significantly differed (P <.001) across the different influenza subtypes.
Overall specificity of QV was high across all flu subtypes, but overall sensitivity was low (Flu A/pdm H1) to moderate (Flu A/H3 and Flu B). The findings highlight the need to develop more sensitive influenza RDTs to detect circulating influenza strains and the use of the quadrivalent flu vaccine during the annual influenza vaccination.
评估现有快速流感诊断测试（RIDT）的性能以及可能影响其性能的因素非常重要，尤其是当流感毒株的传播动态发生变化时，例如季节性流感毒株的更替和替换。
从菲律宾武装部队卫生服务司令部V Luna医疗中心出现流感样疾病（ILI）的患者中采集鼻拭子，一个拭子使用Quickvue（QV）甲型/乙型流感RIDT（Quidel）进行检测，另一个拭子使用ABI 7500（应用生物系统公司）实时逆转录聚合酶链反应进行检测。估计敏感性、特异性、阳性预测值和阴性预测值。我们确定了预测流感亚型的临床症状，并评估了QV敏感性对（1）循环阈值（Ct）值（控制采集时间）；（2）采集时间（控制Ct值）；以及（3）Ct值和采集时间共同作用的独立性。
在2011年8月至2016年10月期间，对出现ILI的患者（n = 2333）进行了检测。所有亚型的Quickvue敏感性与较低的Ct值（较高的病毒滴度）显著相关（P <.001），并且除了甲型/H3流感（P =.974）外，还与标本采集时间显著相关（P <.05）。不同年龄组的甲型/H3流感（P =.130）、大流行H1/N1流感（P =.207）、甲型/H3流感 + 大流行H1/N1流感（P =.
