Comparative evaluation of five rapid PCR platforms for respiratory virus detection

Abstract

Background The demand for rapid molecular diagnostics for respiratory viruses has increased substantially. Several point-of-care PCR platforms have become available, yet comparative performance data remain limited. Objectives To evaluate the diagnostic accuracy and operational reliability of four rapid PCR platforms for detection of severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), influenza A and B viruses (IAV, IBV), and respiratory syncytial virus (RSV), in comparison with the GeneXpert (Cepheid, USA) platform. Methods Nasopharyngeal swabs from patients with respiratory symptoms were tested using the GeneXpert, positive samples were subsequently analysed on four alternative systems: the 30-minute and 1-hour M10 (SD Biosensor, South Korea) assays, FlashDetect™ Flash10 (Coyote Bioscience, China), Vivalytic (Bosch Healthcare Solutions, Germany), and Galaxy Lite (Igenesis, China). Additional lower viral load samples and cultured IAV/ IBV strains were included. Results A total of 223 GeneXpert positive samples were prospectively analysed. Flash10 showed 94.6% overall agreement, missing SARS-CoV-2 (n = 4, GeneXpert Cycle threshold (Ct) min-max; 37.7–42.2), IAV (n = 5, 32.8–37.7), and IBV (n = 3, 26.5–36.7). Vivalytic showed 83.0% overall agreement, missing SARS-CoV-2 (n = 16, 30.4–42.2), IAV (n=9, 26.8–37.7), IBV (n=9, 27.2–36.7), and RSV (n=4, 31.5–37.0). Galaxy Lite achieved 88.2% overall agreement but failed in 27.2% of test runs. With a smaller sample size the M10 (30-minute) assay showed 98.6% overall agreement with GeneXpert, missing one SARS-CoV-2 case (Ct 39.7). Conclusion Among four platforms, the M10 (30-min version) and Flash10 platforms demonstrated the highest agreement rates with the GeneXpert. The variability in performance highlights the importance of independent platform evaluation.