Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

PLoS One. 2019 May 7;14(5):e0216308. doi: 10.1371/journal.pone.0216308. eCollection 2019.

Abstract

Study objective: To investigate the performance of a rapid RT-PCR assay to detect influenza A/B at emergency department admission.

Methods: This single-center prospective study recruited adult patients attending the emergency department for influenza-like illness. Triage nurses performed nasopharyngeal swab samples and ran rapid RT-PCR assays using a dedicated device (cobas Liat, Roche Diagnostics, Meylan, France) located at triage. The same swab sample was also analyzed in the department of virology using conventional RT-PCR techniques. Patients were included 24 hours-a-day, 7 days-a-week. The primary outcome was the diagnostic accuracy of the rapid RT-PCR assay performed at triage.

Results: A total of 187 patients were included over 11 days in January 2018. Median age was 70 years (interquartile range 44 to 84) and 95 (51%) were male. Nine (5%) assays had to be repeated due to failure of the first assay. The sensitivity of the rapid RT-PCR assay performed at triage was 0.98 (95% confidence interval (CI): 0.91-1.00) and the specificity was 0.99 (95% CI: 0.94-1.00). A total of 92 (49%) assays were performed at night-time or during the weekend. The median time from patient entry to rapid RT-PCR assay results was 46 [interquartile range 36-55] minutes.

Conclusion: Rapid RT-PCR assay performed by nurses at triage to detect influenza A/B is feasible and highly accurate.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital
  • Female
  • France / epidemiology
  • Humans
  • Influenza A virus / genetics*
  • Influenza B virus / genetics*
  • Influenza, Human* / diagnosis
  • Influenza, Human* / epidemiology
  • Influenza, Human* / genetics
  • Influenza, Human* / virology
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques*
  • Point-of-Care Systems*
  • Prospective Studies
  • Reverse Transcriptase Polymerase Chain Reaction*
  • Seasons
  • Specimen Handling

Grants and funding

This work was partly funded by Roche Diagnostics (http://www.roche-diagnostics.fr/), the industrial company that markets the cobas Liat system. Roche Diagnostics had no access to the data and were not involved in the interpretation of the data or the writing of the manuscript. MM received this grant. There was no additional external funding received for this study.