Korean J Clin Microbiol.  2010 Dec;13(4):147-150. 10.5145/KJCM.2010.13.4.147.

Comparison of SD BIOLINE Rapid Influenza Antigen Test Using Two Different Specimens, Nasopharyngeal Swabs and Nasopharyngeal Aspirates

• Bang HI
• Shin JW
• Choi TY
• Park R
• Shin YJ

• KMID: 1461608
• DOI: http://doi.org/10.5145/KJCM.2010.13.4.147

Abstract

BACKGROUND
The pandemic swine origin influenza A/H1N1 2009 virus (H1N1 2009) was rapidly spread out all over the world after it was first found in April, 2009. This study was made to compare the performance of nasopharyngeal swabs and nasopharyngeal aspirates for the SD Bioline rapid influenza antigen test.
METHODS
From Aug to Nov, 2009 the SD Bioline rapid influenza antigen tests were conducted with the nasopharyngeal swabs and the nasopharyngeal aspirates from the 244 specimens of patients who had come to the hospital with influenza-like illness. The data from the examination were compared with the multiplex RT-PCR as a reference standard to obtain sensitivity, specificity, positive predictive value and negative predictive value.
RESULTS
The sensitivity and the specificity of the SD Bioline rapid influenza antigen tests with the nasopharyngeal swabs were 75.8%, and 93.3% respectively, and the sensitivity and specificity with the nasopharyngeal aspirates were 61.3%, and 98.3% respectively.
CONCLUSION
Even if the nasopharyngeal aspirates showed the lower sensitivity than the nasopharyngeal swabs, since the specificity is higher, the nasopharyngeal aspirates are more useful because we can reduce false positive rate.

Keyword

H1N1; Rapid influenza antigen test; Multiplex RT-PCR

MeSH Terms

Humans
Influenza, Human
Pandemics
Sensitivity and Specificity
Swine
Viruses

Reference

1. Peiris JS, Poon LL, Guan Y. Emergence of a novel swine-origin influenza A virus (S-OIV) H1N1 virus in humans. J Clin Virol. 2009; 45:169–73.

2. World Health Organization. First confirmed case of influenza A(H1N1) in Republic of Korea. http://www.wpro.who.int/internet/templates/MED_News_or_Press_Release.aspx?NRMODE=Published&NRNODEGUID=%7B25EF48D3-DD8F-4AE4-B247-11D7EFA2EB0E%7D&NRORIGINALURL=%2Fmedia_centre%2Fnews%2Fnews_20090503.htm&NRCACHEHINT=Guest. [Online] (last visit on 18 May 2010).

3. World Health Organization. Republic of Korea raises alert level as Pandemic (H1N1) 2009 spreads. http://www.wpro.who.int/media_centre/news/news_20090723.htm. [Online] (last visit on 18 May 2010).

4. Hurt AC, Alexander R, Hibbert J, Deed N, Barr IG. Performance of six influenza rapid tests in detecting human influenza in clinical specimens. J Clin Virol. 2007; 39:132–5.

5. Vasoo S, Stevens J, Singh K. Rapid antigen tests for diagnosis of pandemic (Swine) influenza A/H1N1. Clin Infect Dis. 2009; 49:1090–3.

6. Mai LQ, Hien PT, Hang NL, Oh JS, Ha GW, Kwon JA, et al. Evaluation of two lateral-flow chromatographic membrane immunoassays for rapid detection of influenza virus in limited respiratory specimens. J Lab Med Qual Assur. 2005; 27:243–9.

7. WHO. WHO information for laboratory diagnosis of pandemic (H1N1) 2009 virus in humans-revised. http://www.who.int/csr/resources/publications/swineflu/WHO_Diagnostic_RecommendationsH1N1_20090521.pdf. [Online] (last visited on Nov 2009).

8. Hwang Y, Kim K, Lee M. Evaluation of the efficacies of rapid antigen test, multiplex PCR, and realtime PCR for the detection of a novel influenza a (H1N1) virus. Korean J Lab Med. 2010; 30:147–52.

9. Agoritsas K, Mack K, Bonsu BK, Goodman D, Salamon D, Marcon MJ. Evaluation of the Quidel QuickVue test for detection of influenza A and B viruses in the pediatric emergency medicine setting by use of three specimen collection methods. J Clin Microbiol. 2006; 44:2638–41.

10. Biggs C, Walsh P, Overmyer CL, Gonzalez D, Feola M, Mordechai E, et al. Performance of influenza rapid antigen testing in influenza in emergency department patients. Emerg Med J. 2010; 27:5–7.

11. Chan KH, Peiris JS, Lim W, Nicholls JM, Chiu SS. Comparison of nasopharyngeal flocked swabs and aspirates for rapid diagnosis of respiratory viruses in children. J Clin Virol. 2008; 42:65–9.

12. Kok J, Blyth CC, Foo H, Patterson J, Taylor J, McPhie K, et al. Comparison of a rapid antigen test with nucleic acid testing during cocirculation of pandemic influenza A/H1N1 2009 and seasonal influenza A/H3N2. J Clin Microbiol. 2010; 48:290–1.

13. Drexler JF, Helmer A, Kirberg H, Reber U, Panning M, Müller M, et al. Poor clinical sensitivity of rapid antigen test for influenza A pandemic (H1N1) 2009 virus. Emerg Infect Dis. 2009; 15:1662–4.

14. Welch DF and Ginocchio CC. Role of rapid immunochromatographic antigen testing in diagnosis of influenza A virus 2009 H1N1 infection. J Clin Microbiol. 2010; 48:22–5.

15. Watcharananan S, Kiertiburanakul S, Chantratita W. Rapid influenza diagnostic test during the outbreak of the novel influenza A/H1N1 2009 in Thailand: an experience with better test performance in resource limited setting. J Infect. 2010; 60:86–7.

16. Choi YJ, Kim HJ, Park JS, Oh MH, Nam HS, Kim YB, et al. Evaluation of new rapid antigen test for detection of pandemic influenza A/H1N1 2009 virus. J Clin Microbiol. 2010; 48:2260–2.