Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

Maxime Maignan 1, 2, * Damien Viglino 1, 2 Maud Hablot 1, 2 Nicolas Masson 1, 2 Anne Lebeugle 1, 2 Roselyne Collomb Muret 1, 2 Prudence Mabiala Makele 1, 2 Valérie Guglielmetti 1, 2 Patrice Morand 3, 4 Julien Lupo 3, 4 Virginie Forget 5, 6 Caroline Landelle 5, 6 Sylvie Larrat 3, 4
* Corresponding author
1 HP2 - Laboratoire Hypoxie et Physiopathologies cardiovasculaires et respiratoires [Grenoble]
2 Emergency department [Grenoble]
3 IBS - UMR 5075 - Institut de biologie structurale
4 Laboratoire de Virologie [Grenoble]
5 TIMC-IMAG - Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525
6 Infection Control Unit [Grenoble]
Abstract : STUDY OBJECTIVE: To investigate the performance of a rapid RT-PCR assay to detect influenza A/B at emergency department admission. METHODS: This single-center prospective study recruited adult patients attending the emergency department for influenza-like illness. Triage nurses performed nasopharyngeal swab samples and ran rapid RT-PCR assays using a dedicated device (cobas Liat, Roche Diagnostics, Meylan, France) located at triage. The same swab sample was also analyzed in the department of virology using conventional RT-PCR techniques. Patients were included 24 hours-a-day, 7 days-a-week. The primary outcome was the diagnostic accuracy of the rapid RT-PCR assay performed at triage. RESULTS: A total of 187 patients were included over 11 days in January 2018. Median age was 70 years (interquartile range 44 to 84) and 95 (51%) were male. Nine (5%) assays had to be repeated due to failure of the first assay. The sensitivity of the rapid RT-PCR assay performed at triage was 0.98 (95% confidence interval (CI): 0.91-1.00) and the specificity was 0.99 (95% CI: 0.94-1.00). A total of 92 (49%) assays were performed at night-time or during the weekend. The median time from patient entry to rapid RT-PCR assay results was 46 [interquartile range 36-55] minutes. CONCLUSION: Rapid RT-PCR assay performed by nurses at triage to detect influenza A/B is feasible and highly accurate.
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Maxime Maignan, Damien Viglino, Maud Hablot, Nicolas Masson, Anne Lebeugle, et al.. Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season. PLoS ONE, Public Library of Science, 2019, 14 (5), pp.e0216308. ⟨10.1371/journal.pone.0216308⟩. ⟨inserm-02196624⟩

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