Performance Assessment of a Rapid Molecular Respiratory Syncytial Virus Point-of-Care Test: A Prospective Community Study in Older Adults Journal Articles uri icon

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abstract

  • Abstract Background Respiratory syncytial virus (RSV) causes a substantial burden in older adults. Viral load in RSV-infected adults is generally lower compared to young children, which could result in suboptimal sensitivity of RSV diagnostics. Although the Xpert® Xpress Flu/RSV assay has been used in routine clinical care, its sensitivity to diagnose RSV infection in older adults is largely unknown. We aimed to compare the performance of the Xpert® Xpress Flu/RSV assay with real-time reverse-transcription polymerase chain reaction (RT-PCR) in home-dwelling older adults (≥60 years of age). Methods Nasopharyngeal swabs were tested with Xpert® Xpress Flu/RSV and compared to RSV RT-PCR in older adults with acute respiratory tract infections with different levels of disease severity. Results We studied 758 respiratory samples from 561 older adults from 2 consecutive RSV seasons. Thirty-five (4.6%) samples tested positive for RSV by at least 1 of the assays, of which 2 samples were negative by Xpert® Xpress Flu/RSV and 3 samples by real-time RT-PCR. The positive percentage agreement (PPA) was 90.9% (95% confidence interval [CI], 76.4%–96.8%) and negative percentage agreement was 99.7% (95% CI, 99.0%–99.9%). Viral loads were low (≤103 copies/mL or cycle threshold value ≥34) in all cases with discordant results for the 2 assays. Conclusions The PPA of Xpert® Xpress Flu/RSV compared to routine RT-PCR is high for RSV detection in home-dwelling older adults. The assay is fast and easy to use at the point of care. Clinical Trials Registration NCT03621930.

authors

  • Zuurbier, Roy P
  • Korsten, Koos
  • Verheij, Theo JM
  • Butler, Christopher
  • Adriaenssens, Niels
  • Coenen, Samuel
  • Gruselle, Olivier
  • Vantomme, Valerie
  • van Houten, Marlies A
  • Bont, Louis J
  • Wildenbeest, Joanne G
  • Zuurbier, Roy
  • Korsten, Koos
  • Verheij, Theo
  • van Houten, Marlies
  • Bont, Louis
  • Wildenbeest, Joanne
  • Adriaenssens, Niels
  • Coenen, Samuel
  • Butler, Christopher
  • Pollard, Andrew
  • Vantomme, Valerie
  • Gruselle, Olivier
  • Leach, Amanda
  • Nair, Harish
  • Campbell, Harry
  • Beutels, Philippe
  • Openshaw, Peter
  • Martinon-Torres, Federico
  • Heikkinen, Terho
  • Meijer, Adam
  • Fischer, Thea Kølsen
  • van den Berge, Maarten
  • Giaquinto, Carlo
  • Abram, Michael
  • Swanson, Kena
  • Aerssens, Jeroen
  • Demont, Clarisse
  • Gallichan, Scott
  • Rosen, Brian
  • Molero, Eva

publication date

  • August 12, 2022