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Liu YL, Xie TA, Lin GL, Deng W, Lin QR, Pan ZY, Fan SJ, Li ZX, Ouyang S, Zhu GD, Ji TX, Wu LJ, Xia Y, Guo XG. Diagnostic accuracy of Xpert Xpress Flu/RSV for detection of Influenza and Respiratory syncytial virus. Jpn J Infect Dis 2021; 75:183-191. [PMID: 34053954 DOI: 10.7883/yoken.jjid.2020.987] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Xpert Xpress Flu/RSV is a fast and automated real-time nucleic acid amplification tool for detecting influenza virus and respiratory syncytial virus (RSV). The aim of this study was to verify the accuracy of Xpert Xpress Flu/RSV in detecting influenza virus and RSV. PubMed, EMBASE, Cochrane Library, and Web of Science were searched up to October 2020. The quality of original research was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 guidelines. Meta-DiSc 1.4 software was used to analyze the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and Summary receiver operating characteristic curve. Deek's funnel plot asymmetry test was used to evaluate the publication bias by Stata 12.0. Ten studies with 25 fourfold tables were included in this analysis. The sensitivity of Xpert Xpress Flu/RSV in detecting influenza A, influenza B, and RSV was 0.97, 0.98, 0.96, respectively, and the specificity was 0.97, 1.00, 1.00, respectively. Compared with other common clinical real-time reverse transcriptase PCR (RT-PCR), Xpert Xpress Flu/RSV is a valuable tool for diagnosing influenza virus and RSV with high sensitivity and specificity.
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Affiliation(s)
- Ye-Ling Liu
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Tian-Ao Xie
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Geng-Ling Lin
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Wei Deng
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Qin-Rong Lin
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Zhi-Yong Pan
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Shu-Jin Fan
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China
| | - Zhen-Xing Li
- Department of Respiratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China
| | - Shi Ouyang
- Department of Infectious Disease, The Fifth Affiliated Hospital of Guangzhou Medical University, China
| | - Guo-Dong Zhu
- Department of Geriatrics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, China
| | - Tian-Xing Ji
- Department of Clinical Medicine, The Second Affiliated Hospital of Guangzhou Medical University, China
| | - Li-Juan Wu
- Baoan Maternal and Child Health Hospital of Jinan University, China
| | - Yong Xia
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, China.,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, China
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Zou X, Chang K, Wang Y, Li M, Zhang W, Wang C, Lu B, Xiong Z, Han J, Zhang Y, Zhao J, Cao B. Comparison of the Cepheid Xpert Xpress Flu/RSV assay and commercial real-time PCR for the detection of influenza A and influenza B in a prospective cohort from China. Int J Infect Dis 2019; 80:92-97. [PMID: 30634045 DOI: 10.1016/j.ijid.2018.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/17/2018] [Revised: 12/14/2018] [Accepted: 12/16/2018] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND The Xpert Xpress Flu/RSV assay is released by FDA for rapid detection of influenza A (FluA), influenza B (FluB), and respiratory syncytial virus (RSV). This study aimed to evaluate its clinical performance in comparison to that of the RT-PCR assay cleared by China FDA (CFDA-PCR). METHODS Nasopharyngeal specimens were collected from patients and tested by the two assays side by side. Discordant results were tested with a laboratory-developed real-time PCR for resolution. Viral load in the sample was quantified with a droplet digital PCR. RESULTS A total of 658 specimens were involved and gave 94.7%-99.1% agreement between the two assays. The Xpert assay showed higher sensitivity for FluA (100% vs. 89.8%) and FluB detection (100% vs. 95.3%), and also higher accuracy (98.9% vs. 95.7%) for FluA than the CDFA-PCR. The positive and negative predictive values (NPV) for the three viruses ranged from 90.5% to 100% in the two assays, with higher NPV for FluA and FluB in Xpert assay. Moreover, the Xpert Ct values showed a linear correlation with virus titer in specimens tested. CONCLUSION Overall, the Xpert assay is a reliable and sensitive tool for the detection of FluA, FluB and RSV in our clinical settings.
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Affiliation(s)
- Xiaohui Zou
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China
| | - Kang Chang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China
| | - Mengxue Li
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Wang Zhang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Chunlei Wang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Binghuai Lu
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Zhujia Xiong
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Jiajing Han
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Yulin Zhang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Jiankang Zhao
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, China-Japan Friendship Hospital, China; Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China; Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China.
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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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