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Arakawa Y, Nishida Y, Sakanashi D, Nakamura A, Ota H, Tokuhiro S, Mikamo H, Yamagishi Y. Clinical evaluation of a modified SARS-CoV-2 rapid molecular assay, ID NOW ™ COVID-19 2.0. J Infect Chemother 2024:S1341-321X(24)00073-4. [PMID: 38437982 DOI: 10.1016/j.jiac.2024.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/10/2024] [Accepted: 02/29/2024] [Indexed: 03/06/2024]
Abstract
In the diagnosis of coronavirus disease 2019 (COVID-19), several types of instruments and reagents for SARS-CoV-2 nucleic acid testing have been introduced to meet clinical needs. We evaluated the clinical performances of ID NOW™ COVID-19 2.0 (ID NOW™ 2.0), which is capable of detecting SARS-CoV-2 within 12 min as part of point-of-care testing (POCT). Patients who displayed COVID-19 related symptoms, and who were tested for screening purposes, were recruited to this study. Two nasopharyngeal swabs were collected and tested using the ID NOW™ 2.0 test. Reference testing was performed using the cobas 8800 or 6800 (reagents: cobas SARS-CoV-2 and Flu A/B). A total of 38 samples and 46 samples were tested positive and negative, respectively, by the reference test. The ID NOW™ 2.0 showed a sensitivity of 94.7% (95% CI: 82.3-99.4) and a specificity of 100% (95% CI: 92.3-100). Samples that were positive by reference testing had cycle threshold (Ct) values ranging from 11.90 to 35.41. Among these reference positive samples, two samples were negative by ID NOW™ 2.0 with Ct values of 35.25 and 35.41. For samples with Ct values < 35, the sensitivity of ID NOW™ 2.0 was 100%. In Japan, the restrictions related to COVID-19 have been relaxed, however the COVID-19 epidemic still continues. ID NOW™ 2.0 is expected to be used as a rapid and reliable alternative to laboratory-based RT-PCR methods.
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Affiliation(s)
- Yu Arakawa
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan; Department of Infection Prevention and Control, Kochi Medical School Hospital, Kochi, Japan
| | - Yoshie Nishida
- Department of Infection Prevention and Control, Kochi Medical School Hospital, Kochi, Japan; Department of Clinical Laboratory, Kochi Medical School Hospital, Kochi, Japan
| | - Daisuke Sakanashi
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Akiko Nakamura
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Hirotoshi Ota
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan
| | - Shinji Tokuhiro
- Department of Clinical Laboratory, Kochi Medical School Hospital, Kochi, Japan
| | - Hiroshige Mikamo
- Department of Infection Prevention and Control, Aichi Medical University Hospital, Aichi, Japan; Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Kochi Medical School, Kochi University, Kochi, Japan; Department of Infection Prevention and Control, Kochi Medical School Hospital, Kochi, Japan.
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Hong KH, Kim GJ, Roh KH, Sung H, Lee J, Kim SY, Kim TS, Park JS, Huh HJ, Park Y, Kim JS, Kim HS, Seong MW, Ryoo NH, Song SH, Lee H, Kwon GC, Yoo CK. Update of Guidelines for Laboratory Diagnosis of COVID-19 in Korea. Ann Lab Med 2022; 42:391-397. [PMID: 35177559 PMCID: PMC8859556 DOI: 10.3343/alm.2022.42.4.391] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 11/19/2022] Open
Abstract
Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have announced guidelines for diagnosing coronavirus disease (COVID-19) in clinical laboratories in Korea. With the ongoing pandemic, we propose an update of the previous guidelines based on new scientific data. This update includes recommendations for tests that were not included in the previous guidelines, including the rapid molecular test, antigen test, antibody test, and self-collected specimens, and a revision of the previous recommendations. This update will aid clinical laboratories in performing laboratory tests for diagnosing COVID-19.
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Affiliation(s)
- Ki Ho Hong
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gab Jung Kim
- Bureau of Infectious Disease Diagnosis Control, the Korea Disease Control and Prevention Agency, Osong, Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Taek Soo Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae-Sun Park
- Bureau of Infectious Disease Diagnosis Control, the Korea Disease Control and Prevention Agency, Osong, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Younhee Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Nam Hee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Sang Hoon Song
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Cheon Kwon Yoo
- Bureau of Infectious Disease Diagnosis Control, the Korea Disease Control and Prevention Agency, Osong, Korea
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Li ZP, Mao WH, Huang F, Wang N, Ma LP, Zhang LQ, Gao MQ, Wang WB, Zhao Q, Tang SL. Access to quality diagnosis and rational treatment for tuberculosis: real-world evidence from China-Gates Tuberculosis Control Project Phase III. Infect Dis Poverty 2021; 10:92. [PMID: 34187558 PMCID: PMC8243738 DOI: 10.1186/s40249-021-00875-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background China has successfully reduced tuberculosis (TB) incidence rate over the past three decades, however, challenges remain in improving the quality of TB diagnosis and treatment. In this paper, we assess the effects of the implementation of “China National Health Commission (NHC) and Gates Foundation TB Prevention and Control Project” on the quality of TB care in the three provinces. Methods We conducted the baseline study in 2016 and the final evaluations in 2019 in the 12 selected project counties. We obtained TB patients’ information from the TB Information Management System and reviewed medical records of TB cases in the TB designated hospitals. We compared TB diagnosis and treatment services with the national practice guideline and used Student’s t-test and Pearson χ2 tests or Fisher’s exact tests to compare the difference before and after the project implementation. Results The percentage of sputum smear-negative (SS–) patients taking culture or rapid molecular test (RMT) doubled between 2015 and 2018 (from 35% to 87%), and the percentage of bacteriologically confirmed pulmonary TB cases increased from 36% to 52%. RMT has been widely used and contributed an additional 20% of bacteriologically confirmed TB cases in 2018. The percentage of TB patients taking drug susceptibility tests (DST) also doubled (from 40% in 2015 to 82% in 2018), and the proportion of TB patients receiving adequate diagnosis services increased from 85% to 96%. Among all SS– TB patients, over 86% received the recommended diagnostic services at the end of the study period, an improvement from 75% prior to the project implementation. However, the proportion of TB patients treated irrationally using second-line anti-TB drugs (SLDs) increased from 12.6% in 2015 to 19.9% in 2018. The regional disparities remained within the project provinces, albeit the gaps between them narrowed down for almost all indicators. Conclusions The quality of TB diagnosis services has been improved substantially, which is attributable to the coverage of new diagnosis technology. However, irrational use of SLDs remains a concern after the project implementation. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00875-8.
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Affiliation(s)
- Zhi-Peng Li
- School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 20032, China
| | - Wen-Hui Mao
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
| | - Fei Huang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ni Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li-Ping Ma
- Beijing Chest Hospital, 97 Machang, Tongzhou, Beijing, China
| | - Li-Qun Zhang
- Beijing Chest Hospital, 97 Machang, Tongzhou, Beijing, China
| | - Meng-Qiu Gao
- Beijing Chest Hospital, 97 Machang, Tongzhou, Beijing, China.
| | - Wei-Bing Wang
- School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 20032, China
| | - Qi Zhao
- School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 20032, China.
| | - Sheng-Lan Tang
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
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Kitano T, Nishikawa H, Suzuki R, Onaka M, Nishiyama A, Kitagawa D, Oka M, Masuo K, Yoshida S. The impact analysis of a multiplex PCR respiratory panel for hospitalized pediatric respiratory infections in Japan. J Infect Chemother 2019; 26:82-85. [PMID: 31383498 PMCID: PMC7128379 DOI: 10.1016/j.jiac.2019.07.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/11/2019] [Accepted: 07/18/2019] [Indexed: 01/18/2023]
Abstract
Background Rapid molecular diagnosis of infections has contributed to timely treatments and antimicrobial stewardship. However, the benefit and cost-effectiveness vary in each country or community because they have different standard practices and health care systems. In Japan, rapid antigen tests (RATs) have been frequently used for pediatric respiratory infections. We investigated the impact and cost-effectiveness of a multiplex PCR (mPCR) respiratory panel for pediatric respiratory infections in a Japanese community hospital. Methods We replaced RATs with an mPCR respiratory panel (FilmArray®) for admitted pediatric respiratory infections on March 26, 2018. We compared the days of antimicrobial therapy (DOT) and length of stay (LOS) during the mPCR period (March 2018 to April 2019) with those of the RAT period (March 2012 to March 2018). Results During the RAT and mPCR periods, 1132 and 149 patients were analyzed. The DOT/case was 12.82 vs 8.56 (p < 0.001), and the LOS was 8.18 vs 6.83 days (p = 0.032) in the RAT and mPCR groups, respectively. The total costs during admissions were ∖258,824 ($2331.7) and ∖243,841 ($2196.8)/case, respectively. Pathogen detection rates were 30.2% vs 87.2% (p < 0.001). Conclusion Compared to conventional RATs, the mPCR test contributed to a reduction in the DOT and LOS in a Japanese community hospital for admission-requiring pediatric respiratory infections. However, a proper stewardship program is essential to further reduce the unnecessary usage of antimicrobials.
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Affiliation(s)
- Taito Kitano
- Department of Pediatrics, Nara Medical University Hospital, 840 Shijo, Kashihara, Nara, 6348521, Japan.
| | - Hiroki Nishikawa
- Department of Pediatrics, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Rika Suzuki
- Department of Pediatrics, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Masayuki Onaka
- Department of Pediatrics, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Atsuko Nishiyama
- Department of Pediatrics, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Daisuke Kitagawa
- Department of Microbiology, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Miyako Oka
- Department of Microbiology, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Kazue Masuo
- Department of Microbiology, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
| | - Sayaka Yoshida
- Department of Pediatrics, Nara Prefecture General Medical Center, 2-897-5 Shichijo West, Nara, Nara, 6308581, Japan
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Rodrigues C, Siciliano RF, Filho HC, Charbel CE, de Carvalho Sarahyba da Silva L, Baiardo Redaelli M, de Paula Rosa Passetti AP, Franco MRG, Rossi F, Zeigler R, De Backer D, Franco RA, de Almeida JP, Rizk SI, Fukushima JT, Landoni G, Uip DE, Hajjar LA, Strabelli TMV. The effect of a rapid molecular blood test on the use of antibiotics for nosocomial sepsis: a randomized clinical trial. J Intensive Care 2019; 7:37. [PMID: 31367384 PMCID: PMC6647273 DOI: 10.1186/s40560-019-0391-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/08/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Appropriate use of antimicrobials is essential to improve outcomes in sepsis. The aim of this study was to determine whether the use of a rapid molecular blood test-SeptiFast (SF) reduces the antibiotic consumption through early de-escalation in patients with nosocomial sepsis compared with conventional blood cultures (BCs). METHODS This was a prospective, randomized, superiority, controlled trial conducted at Sao Paulo Heart Institute in the period October 2012-May 2016. Adult patients admitted to the hospital for at least 48 h with a diagnosis of nosocomial sepsis underwent microorganism identification by both SF test and BCs. Patients randomized into the intervention group received antibiotic therapy adjustment according to the results of SF. Patients randomized into the control group received standard antibiotic adjustment according to the results of BCs. The primary endpoint was antimicrobial consumption during the first 14 days after randomization. RESULTS A total of 200 patients were included (100 in each group). The intention to treat analysis found no significant differences in median antibiotic consumption. In the subgroup of patients with positive SF and blood cultures (19 and 25 respectively), we found a statistically significant reduction in the median antimicrobial consumption which was 1429 (1071-2000) days of therapy (DOT)/1000 patients-day in the intervention group and 1889 (1357-2563) DOT/1000 patients-day in the control group (p = 0.017), in the median time of antimicrobial de-escalation (8 versus 54 h-p < 0.001), in the duration of antimicrobial therapy (p = 0.039) and in anti-gram-positive antimicrobial costs (p = 0.002). Microorganism identification was possible in 24.5% of patients (45/184) by SF and 21.2% (39/184) by BC (p = 0.45). CONCLUSION This randomized clinical trial showed that the use of a rapid molecular-based pathogen identification test does not reduce the median antibiotic consumption in nosocomial sepsis. However, in patients with positive microbiological tests, the use of SeptiFast reduced antimicrobial consumption through early de-escalation compared to conventional blood cultures. These results were driven by a reduction in the consumption of antimicrobials used for Gram-positive bacteria. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov (NCT01450358) on 12th October 2011.
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Affiliation(s)
- Cristhieni Rodrigues
- Infectious Diseases Control, Heart Institute, University of Sao Paulo, São Paulo, Brazil
| | | | | | | | | | - Martina Baiardo Redaelli
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University of Milan, Milan, Italy
| | | | | | - Flávia Rossi
- Microbiology Division, University of Sao Paulo, São Paulo, Brazil
| | - Rogerio Zeigler
- Infectious Diseases Control, Heart Institute, University of Sao Paulo, São Paulo, Brazil
| | - Daniel De Backer
- Department of Intensive Care at the Erasme University, Universite Libre de Bruxelles, Bruxelles, Belgium
| | - Rafael Alves Franco
- Intensive Care Unit, Instituto do Cancer, University of Sao Paulo, São Paulo, Brazil
| | | | - Stéphanie Itala Rizk
- Intensive Care Unit, Instituto do Cancer, University of Sao Paulo, São Paulo, Brazil
| | - Julia Tizue Fukushima
- Intensive Care Unit, Instituto do Cancer, University of Sao Paulo, São Paulo, Brazil
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University of Milan, Milan, Italy
| | - David Everson Uip
- Infectious Diseases Control, Heart Institute, University of Sao Paulo, São Paulo, Brazil
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Chen JH, Lam HY, Yip CC, Cheng VC, Chan JF, Leung TH, Sridhar S, Chan KH, Tang BS, Yuen KY. Evaluation of the molecular Xpert Xpress Flu/RSV assay vs. Alere i Influenza A & B assay for rapid detection of influenza viruses. Diagn Microbiol Infect Dis 2017; 90:177-180. [PMID: 29262988 DOI: 10.1016/j.diagmicrobio.2017.11.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 11/08/2017] [Accepted: 11/17/2017] [Indexed: 11/30/2022]
Abstract
A new FDA-approved Xpert Xpress Flu/RSV assay has been released for rapid influenza virus detection. We collected 134 nasopharyngeal specimens to compare the diagnostic performance of the Xpert assay and the Alere i Influenza A & B assay for influenza A and B virus detection. The Xpert assay demonstrated 100% and 96.3% sensitivity to influenza A and influenza B virus respectively. Its specificity was 100% for both viruses. The Alere i assay demonstrated slightly lower sensitivity but similar specificity to the Xpert Xpress assay. Although the Xpert assay (30 min) required longer processing time than the Alere assay (15 min), the handling procedure of the Alere assay was more complicated than the Xpert assay. As the GenXpert system has higher throughput than the Alere system, it is more suitable for hospital clinical laboratories. Overall, the new Xpert Xpress Flu/RSV assay is a reliable and useful tool for rapid influenza detection.
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Affiliation(s)
- J H Chen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - H Y Lam
- Department of Pathology, Hong Kong Sanatorium and Hospital, Hong Kong Special Administrative Region, China
| | - C C Yip
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - V C Cheng
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Infection Control Team, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - J F Chan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - T H Leung
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China
| | - S Sridhar
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - K H Chan
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - B S Tang
- Department of Pathology, Hong Kong Sanatorium and Hospital, Hong Kong Special Administrative Region, China
| | - K Y Yuen
- Department of Microbiology, Queen Mary Hospital, Hong Kong Special Administrative Region, China; Carol Yu Centre for Infection, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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