Clinical evaluation of multiplex RT-PCR assays for the detection of influenza A/B and respiratory syncytial virus using a high throughput system

J Virol Methods. 2019 Jul:269:49-54. doi: 10.1016/j.jviromet.2019.03.015. Epub 2019 Apr 1.

Abstract

Background: Lower respiratory tract infections are a major threat to public health systems worldwide, with RSV and influenza being the main agents causing hospitalization. In outbreak situations, high-volume respiratory testing is needed. In this study, we evaluated the analytical and clinical performance of a pre-designed primer/probe set for the simultaneous multiplex detection of both viruses on a high-throughput platform, the cobas® 6800, using the "open channel" of the system for integration of lab-developed assays for the detection of influenza and RSV.

Results: Using the influenza/RSV qPCR Assay with swabs, LoD (95%) in TCID50/mL for influenza-A was 0.009, influenza-B 0.003, RSV-A 0.202, and RSV-B 0.009. Inter-run variability (3xLoD) was low (<1 Ct for all targets). Of 371 clinical respiratory specimens analyzed, results were concordant for 358 samples. The calculated sensitivity and specificity of the assay were 98.3% and 98.4% for Flu-A, 100% and 98.5% for Flu-B, and 98.6% and 99.7% for RSV. All quality assessment panel specimens (N = 63, including avian influenza strains) were correctly identified. None of the tested microorganisms showed cross-reactivity.

Conclusion: Compared with CE-IVD assays, the assay evaluated here showed good analytical and clinical sensitivity and specificity with broad coverage of different virus strains. It offers high-throughput capacity with low hands-on time, facilitating the laboratory management of large respiratory outbreaks.

Keywords: Influenza, human; Multiplex real-time PCR; Respiratory syncytial viruses.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Birds / virology
  • High-Throughput Screening Assays / methods*
  • Humans
  • Influenza A virus / isolation & purification*
  • Influenza B virus / isolation & purification*
  • Influenza in Birds / virology
  • Influenza, Human / diagnosis
  • Influenza, Human / virology
  • Multiplex Polymerase Chain Reaction*
  • Nasopharynx / virology
  • Respiratory Syncytial Virus Infections / diagnosis
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Virus, Human / isolation & purification*
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / virology
  • Sensitivity and Specificity