AI Article Synopsis

  • Respiratory syncytial virus (RSV) significantly affects older adults, but the diagnostic sensitivity for this age group using the Xpert® Xpress Flu/RSV assay is not well understood.
  • This study tested nasopharyngeal swabs from 561 older adults to compare the effectiveness of the Xpert® assay against standard real-time RT-PCR for RSV detection.
  • Results showed a high positive percentage agreement (90.9%) and very high negative agreement (99.7%) between the two assays, indicating that the Xpert® assay is a reliable and quick option for diagnosing RSV in older adults at home.

Article 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9374508PMC
http://dx.doi.org/10.1093/infdis/jiab600DOI Listing

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