Evaluation of a new latex agglutination test for detecting human rotavirus in faeces

Evaluation of a commercial latex agglutination test for detecting rotavirus A and human adenovirus in children's stool specimens

Objectives

Rotavirus A and human adenovirus are the two most common causes of infantile diarrhea; thus, it is of great importance to find out a rapid and accurate diagnostic method. This study aimed to evaluate the diagnostic significance of latex agglutination test for detection of rotavirus A and human adenovirus.

Methods

A prospective study was conducted on 214 diarrhea children from September 2018 to March 2019 in our hospital. Fresh stool samples were collected for detection of rotavirus A and human adenovirus by latex agglutination test and quantitative reverse transcription polymerase chain reaction (RT‐qPCR). Then, the consistency of results detected by these two methods was analyzed．

Results

With performing the latex agglutination test, it was revealed that positive rates for detecting rotavirus A virus and human adenovirus were 23.83% (51/214) and 25.24% (54/214), respectively. Meanwhile, results of RT‐qPCR showed that positive rates for detecting rotavirus A virus and human adenovirus were 58 (27.10%) and 59 (27.57%), respectively. Using RT‐qPCR as the gold standard, the sensitivity and specificity of the latex agglutination test for detecting rotavirus A were 81.03% and 97.44%, and the corresponding values for detecting human adenovirus were 76.27% and 94.19%, respectively.

Conclusion

This latex agglutination test showed a satisfactory consistency with RT‐qPCR for detecting rotavirus A and human adenovirus. The mentioned commercial assay may be highly appropriate for rapid screening of rotavirus A and human adenovirus.

Human viral gastroenteritis

During the last 15 years, several different groups of fastidious viruses that are responsible for a large proportion of acute viral gastroenteritis cases have been discovered by the electron microscopic examination of stool specimens. This disease is one of the most prevalent and serious clinical syndromes seen around the world, especially in children. Rotaviruses, in the family Reoviridae, and fastidious fecal adenoviruses account for much of the viral gastroenteritis in infants and young children, whereas the small caliciviruses and unclassified astroviruses, and possibly enteric coronaviruses, are responsible for significantly fewer cases overall. In addition to electron microscopy, enzyme immunoassays and other rapid antigen detection systems have been developed to detect rotaviruses and fastidious fecal adenoviruses in the stool specimens of both nonhospitalized patients and those hospitalized for dehydration and electrolyte imbalance. Experimental rotavirus vaccines have also been developed, due to the prevalence and seriousness of rotavirus infection. The small, unclassified Norwalk virus and morphologically similar viruses are responsible for large and small outbreaks of acute gastroenteritis in older children, adolescents, and adults. Hospitalization of older patients infected with these viruses is usually not required, and their laboratory diagnoses have been limited primarily to research laboratories.

Rapid and accurate viral diagnosis

In recent years, there has been increased recognition of the importance of viral infections. In addition, new antiviral agents have become available. These factors have led to a marked increase in utilization of viral diagnostic services. In this review, both conventional and rapid methods for viral diagnosis are presented, with emphasis on recent advances. The antiviral agents currently available and the major drugs under investigation are also briefly discussed. It is hoped that this review will serve as a useful adjunct for the management of patients with virus infections.

Evaluation of Abbott TESTPACK ROTAVIRUS with clinical specimens

TESTPACK ROTAVIRUS was compared with the Pathfinder Rotavirus assay for the detection of rotaviral antigens in feces from 137 patients. The symptomatology and ages of the patients varied from no symptoms to watery diarrhea and from less than 3 months to greater than 60 years of age. The sensitivity and specificity, before resolution, were 89.2 and 90.0%, respectively. After resolution with a blocking reagent, the results were 100% sensitivity and 98.9% specificity. The performance was similar for all age groups and in both symptomatic and asymptomatic patients. Abbott TESTPACK ROTAVIRUS is a rapid (10-min), easy-to-perform assay for the detection of rotaviral antigens and has the sensitivity and specificity of enzyme-linked immunosorbent assays that require several hours to perform.

Detection of rotavirus in faecal specimens by enzyme immunoassay, latex agglutination and electron microscopy

Faecal specimens from 570 patients with gastroenteritis were studied for rotaviruses by enzyme immunoassay (EIA), electron microscopy (EM) and latex agglutination test (LX). Specimens from 127 patients were positive and 379 were negative with all 3 methods. 64 (11%) specimens gave contradictory results in the tests. EIA gave significantly more positive results than EM (168 vs 145). 30 EM-negative and EIA-positive specimens were positive in a confirmatory test. LX was positive in 161 specimens and no significant differences to EM or EIA were observed. There were 16 (2.8%) LX-positive samples that were negative both in EM and EIA. The positivity of these samples could not be confirmed and 15 of them were only slightly positive. Our results can be concluded: (1) Enzyme immunoassay may be more sensitive than electron microscopy but requires a confirmatory test and is tedious when only a few specimens per day are to be examined; (2) LX seems to be suitable for primary screening of faecal specimens for rotavirus; for definitely positive results the test is reliable.

Detection of rotavirus by a latex agglutination test, Rotalex: comparison with electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay

A commercially available latex agglutination test, Rotalex (Orion Diagnostics, Finland), for detecting rotaviruses was evaluated in comparison with four other tests (electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay) routinely used in our laboratories. Although Rotalex was the least complex method, it showed lack of specificity and sensitivity when carried out according to the manufacturer's instructions. Four basic modifications of Rotalex are described. These include the use of Hank's balanced salt solution, increasing the incubation time to 20 min, reading the agglutination result by an experienced observer, and the use of 50 mm square glass plates. The modified procedure gave results which were comparable with those obtained by electron microscopy, immunofluorescence, polyacrylamide gel electrophoresis, and enzyme linked immunosorbent assay. The latter techniques, when used to detect rotavirus, all gave similar results.

Evaluation of two commercial kits for rapid detection of human rotavirus in feces: Rotalex, a latex agglutination test and Rotavirus ELISA Kit

96 fecal specimens from children with symptoms of gastroenteritis were tested with a latex agglutination test (Rotalex, Orion Diagnostica, Finland) and an enzyme-linked immunosorbent test (Rotavirus ELISA Kit, Dakopatts, Copenhagen, Denmark). Using the ELISA method as reference, the latex agglutination (LX) came out with three non-specific and two false negative results. The LX test was found to be a rapid, practical and non-expensive choice for a laboratory examinating few samples daily.