Abstract
The molecular diagnosis of respiratory infection can be performed using different commercial multiplex-based PCR kits whose performances have been previously compared individually to those of conventional techniques. This study compared the practicability and the diagnostic performances of six CE-marked kits available in 2011 on the French market, including 2 detecting viruses and atypical bacteria (from Pathofinder and Seegene companies) and 4 detecting only viruses (from Abbott, Genomica, Qiagen and Seegene companies). The respective sensitivity, specificity, accuracy and agreement of each multiplex technique were calculated by comparison to commercial duplex PCR tests (Argene/bioMérieux) used as gold standard. Eighty-eight respiratory specimens with no pathogen (n = 11), single infections (n = 33) or co-infections (n = 44) were selected to cover 9 viruses or groups of viruses and 3 atypical bacteria. All samples were extracted using the NUCLISENS® easyMAG™ instrument (bioMérieux). The overall sensitivity ranged from 56.25% to 91.67% for viruses and was below 50% with both tests for bacteria. The overall specificity was excellent (>94% for all pathogens). For each tested kit, the overall agreement with the reference test was strong for viruses (kappa test >0.60) and moderate for bacteria. After the extraction step, the hands-on time varied from 50 min to 2h30 and the complete results were available in 2h30 to 9 h. The spectrum of tested agents and the technology used to reveal the PCR products as well as the laboratory organization are determinant for the selection of a kit.
Highlights
The global burden of acute respiratory infection (ARI) remains a huge problem of Public Health
A wide range of pathogens are involved in ARI, including bacteria and viruses
Presentation of the Kits used in this Study Six kits based on multiplex detection of respiratory viruses or atypical bacteria and available in the French market in 2011 were tested
Summary
The global burden of acute respiratory infection (ARI) remains a huge problem of Public Health. The number of viral respiratory episodes per year has been estimated between 6 and 10 in children before school age versus 3 to 5 in those after this age and ARI represents the cause of 30 to 40% of hospital admissions in this category of patients [1] [2]. A wide range of pathogens are involved in ARI, including bacteria and viruses. The identification of the causative agent(s) is often omitted or limited to a few pathogens easy to detect by rapid antigen direct tests (influenza viruses and respiratory syncytial virus (RSV) in respiratory specimens, Streptococcus pneumoniae and Legionella pneumophila in urine specimens). The distinction between viral and bacterial infections is often impossible by using nonmicrobiological criteria [3,4]
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