Journal List > Korean J Lab Med > v.27(3) > 1011392

Lee and Lee: Evaluation of SD BIOLINE Tetanus Kit

Abstract

Background

Point-of-care-testing (POCT) kits for tetanus toxoid antibody are used in emergency departments to evaluate the immunization status of patients with tetanus. The objective of this study was to evaluate the analytical performance and the utility of SD BIOLINE tetanus kit (Standard Diagnostic Inc., Yongin, Korea), as a POCT.

Methods

A total of 326 peripheral blood specimens (whole blood, 319; serum, 326) from healthy subjects and patients were used. SD BIOLINE tetanus kit was evaluated for precision, accuracy, effect of specimens, operator variance, and the total processing time. The results from SD BIOLINE tetanus kit were compared with those from 2 quantitative ELISA kits.

Results

Compared with ELISA kits, SD BIOLINE tetanus kit revealed a sensitivity of 88–97%, specificity of 87–92%, positive predictive value of 81–89%, negative predictive value of 90–98%, and kappa agreement of 0.78–0.82. SD BIOLINE tetanus kit also showed an excellent precision and a high accuracy. It showed a high concordance rate between whole blood and serum specimens. The total processing time of SD BIOLINE tetanus kit was 30–40 min.

Conclusions

SD BIOLINE tetanus kit showed an excellent analytical performance. With its rapid turnaround time and the ease of handling and interpretation, SD BIOLINE tetanus kit seems appropriate for the evaluation of tetanus immunization status as a POCT device. However, education for operators and standardized guidelines for result interpretation should be emphasized.

References

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Table 1.
Performance of SD BIOLINE tetanus kit in comparison with two quantative ELISA kits
SD BIOLINE tetanus kit SD BIOLINE tetanus kit vs ELISA 1
SD BIOLINE tetanus kit vs ELISA2
Sensitivity % Specificity % PPV % NPV % Kappa agreement (95%CI) Sensitivity % Specificity % PPV % NPV % Kappa agreement (95%CI)
in whole blood 86.7 91.8 88.6 90.4 0.79 94.8 89.2 83.3 96.7 0.82
(n=319)         (0.72–0.86)         (0.75–0.88)
in serum 88.3 89.9 86.4 91.4 0.78 96.5 87 80.7 97.5 0.8
(n=326)         (0.71–0.85)         (0.74–0.87)

ELISA 1, ELISA anti-tetanus IgG assay (SCIMEDX Co); ELISA2, IBL tetanus Ab. ELISA (IBL IMMUNO BIOLOGICAL LABORATORIES).

Abbreviations: PPV, positive predictive value; NPV, negative predictive value; CI, confidence interval.

Table 2.
Testing results of 3 analytical methods around cut-off (0.1 IU/mL)
Specimen No. ELISA 1 (IU/mL) ELISA 2 (IU/mL) SD BIOLINE tetanus kit
by operator 1 by operator 2
1 0.101 0.113 Negative Negative
2 <0.100 0.124 Negative Negative
3 0.144 <0.100 Negative Negative
4 0.118 <0.100 Negative Negative
5 0.104 <0.100 Positive Negative
6 0.135 0.107 Positive Negative
7 <0.100 0.123 Positive Positive
8 0.100 0.143 Positive Positive
9 0.100 <0.100 Positive Positive
10 0.105 0.127 Positive Positive
11 0.115 0.106 Positive Positive
12 0.128 0.102 Positive Positive
13 0.136 0.120 Positive Positive
14 0.138 0.147 Positive Positive
15 0.145 0.150 Positive Positive

Abbreviations: See Table 1.

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