Comparison of six sample-to-answer influenza A/B and respiratory syncytial virus nucleic acid amplification assays using respiratory specimens from children

Abstract

The rapid and accurate detection of influenza A virus (FluA), influenza Bvirus (FluB), and respiratory syncytial virus (RSV) improves patient care. Sample-toanswer (STA) platforms based on nucleic acid amplification and detection of theseviruses are simple, automated, and accurate. We compared six such platforms forthe detection of FluA, FluB, and RSV: Cepheid GeneXpert Xpress Flu/RSV (Xpert), Hologic Panther Fusion Flu A/B/RSV (Fusion), Cobas influenza A/B &RSV (Liat), LuminexAries Flu A/B &RSV (Aries), BioFire FilmArray respiratory panel (RP), and DiasorinSimplexa Flu A/B &RSV (Simplexa). Nasopharyngeal (NP) swab specimens (n 225)from children previously tested by RP were assessed on these platforms. The resultswere compared to those of the Centers for Disease Control and Prevention (CDC)-developed real-time reverse transcription-PCR (rRT-PCR) assay for influenza A/B viruses and RSV. Subtyping for FluA and FluB was performed for discrepant analysiswhere applicable. The percent sensitivities/specificities for FluA detection were 100/100 (Fusion), 98.6/99.3 (Xpert), 100/100 (Liat), 98.6/100 (Aries), 98.6/100 (Simplexa),and 100/100 (RP). The percent sensitivities/specificities for FluB detection were 100/100 (Fusion), 97.9/99.4 (Xpert), 97.9/98.3 (Liat), 93.7/99.4 (Aries), 85.4/99.4 (Simplexa),and 95.8/97.7 (RP); and those for RSV detection were 98.1/99.4 (Xpert), 98.1/99.4(Liat), 96.3/100 (Fusion), 94.4/100 (Aries), 87/94.4 (Simplexa), and 94.4/100 (RP). The75 strains confirmed to be FluA included 29 pH1N1, 39 H3N2, 4 sH1N1, and 3 untyped strains. The 48 strains confirmed to be FluB included 33 strains of theYamagata lineage, 13 of the Victoria lineage, 1 of both the Yamagata and Victorialineages, and 1 of an unknown lineage. All six STA platforms demonstrated >95%sensitivity for FluA detection, while three platforms (Fusion, Xpert, and Liat) demonstrated >95% sensitivity for FluB and RSV detection.