Journal List > Korean J Clin Microbiol > v.13(3) > 1038188

Korean J Clin Microbiol. 2010 Sep;13(3):109-113. Korean.
Published online September 30, 2010.  https://doi.org/10.5145/KJCM.2010.13.3.109
Copyright © 2010 The Korean Society of Clinical Microbiology
Comparison of Rapid Antigen Test and Real-Time Reverse Transcriptase PCR for Diagnosing Novel Swine Influenza A (H1N1)
Aerin Kwon, Jae-Seok Kim, Han-Sung Kim, Wonkeun Song, Ji-Young Park, Hyoun Chan Cho and Kyu Man Lee
Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, Korea.

Correspondence: Jae-Seok Kim, Department of Laboratory Medicine, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, 445 Gil-dong, Gangdong-gu, Seoul 134-701, Korea. (Tel) 82-2-2224-2327, (Fax) 82-2-2224-2214, Email: jaeseok@hallym.or.kr
Received January 07, 2010; Revised July 06, 2010; Accepted July 20, 2010.

Abstract

Background

Novel swine influenza (H1N1) was first identified in Mexico in April 2009. Because of its high infectivity and worldwide distribution, a rapid and efficient screening test is necessary. Here we evaluated the usefulness of a rapid antigen test currently in use, compared to real-time RT-PCR (rRT-PCR) as a screening test for detection of novel swine influenza (H1N1).

Methods

A total of 1,228 patients who visited Hallym University Kangdong Sacred Heart Hospital with influenza-like illness between 14 August 2009 and 30 September 2009, and were tested by both rapid antigen and rRT-PCR tests, were enrolled in this study.

Results

Sensitivity, specificity, predictive value of a positive test, and predictive value of a negative test for the rapid antigen test were 30.5%, 99.2%, 86.4% and 90.1%, respectively. Fifty-one (4.2%) patients were positive for both rapid antigen test and rRT-PCR, and 1,053 (85.7%) were negative for both rapid antigen test and rRT-PCR. A total of 124 (10.1%) patients showed a discrepancy between the two tests. Among them, 116 (9.4%) were only positive for rRT-PCR and 8 (0.7%) were only positive for the rapid antigen test. The latter 8 patients all showed negative H1/M2 results in rRT-PCR. There were significant differences in detection rates of the rapid antigen test between different H1 Ct (threshold cycle) interval groups and for different age groups (P<0.05).

Conclusion

Although the rapid antigen test is easy to perform and provides fast results, its limits as a screening test for detection of novel swine influenza (H1N1) due to its low sensitivity compared to rRT-PCR need to be considered in practical situations.

Keywords: Novel swine influenza; H1N1; Rapid antigen test; Real-time PCR; Sensitivity

Figures


Fig. 1
Comparison of rapid antigen test sensitivity between different H1 Ct* interval groups among novel swine influenza A (H1N1) patients confirmed by real-time RT-PCR. *Ct, threshold cycle.
Click for larger image

Tables


Table 1
Comparison of rapid antigen test and real-time RT-PCR for detection of novel swine influenza A (H1N1)
Click for larger image


Table 2
Comparison of rapid antigen test results between different age groups among novel swine influenza A (H1N1) patients confirmed by real-time RT-PCR
Click for larger image

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