Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1994 Jan;32(1):70–74. doi: 10.1128/jcm.32.1.70-74.1994

Comparison of rapid detection methods for influenza A virus and their value in health-care management of institutionalized geriatric patients.

G P Leonardi 1, H Leib 1, G S Birkhead 1, C Smith 1, P Costello 1, W Conron 1
PMCID: PMC262972  PMID: 8126207

Abstract

Respiratory specimens from 160 geriatric patients with suspected influenza illness were used to evaluate the abilities of two enzyme immunoassays (EIAs; Directigen FLU-A [Becton Dickinson Microbiology Systems, Cockeysville, Md.] and Prima EIA [Baxter/Bartels Diagnostics, Inc., Issaquah, Wash.]) and direct immunofluorescence testing (immunofluorescence assay [IFA]) to identify influenza A virus. In comparison with culture isolation, the sensitivities and specificities of the IFA, Directigen FLU-A, and Prima EIA were 92.5 and 97.2%, 86.8 and 99.1%, and 92.5 and 98.1%, respectively. In contrast to EIA, IFA was labor intensive and required a high degree of technical expertise, and the results of IFA were difficult to interpret. These factors may preclude the use of IFA for testing large numbers of specimens. A retrospective epidemiologic survey of influenza infection was done in six geriatric institutions which had used either rapid and culture testing or culture alone. Preventable cases of influenza A virus infection ranged from 9 to 38% of all cases in facilities which used culture testing only and which had not instituted amantadine prophylaxis. The use of direct specimen testing is recommended as an adjunct to culture isolation for the identification of influenza A virus. Use of a combination of these methods permits the timely administration of appropriate antiviral therapy and infection control measures, while it also permits the antigenic surveillance of circulating influenza strains, which is necessary for present vaccine efficacy evaluations and the creation of future effective vaccine formulations.

Full text

PDF
74

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arden N. H., Patriarca P. A., Fasano M. B., Lui K. J., Harmon M. W., Kendal A. P., Rimland D. The roles of vaccination and amantadine prophylaxis in controlling an outbreak of influenza A (H3N2) in a nursing home. Arch Intern Med. 1988 Apr;148(4):865–868. [PubMed] [Google Scholar]
  2. Chomel J. J., Pardon D., Thouvenot D., Allard J. P., Aymard M. Comparison between three rapid methods for direct diagnosis of influenza and the conventional isolation procedure. Biologicals. 1991 Oct;19(4):287–292. doi: 10.1016/s1045-1056(05)80017-x. [DOI] [PubMed] [Google Scholar]
  3. Falsey A. R., Treanor J. J., Betts R. F., Walsh E. E. Viral respiratory infections in the institutionalized elderly: clinical and epidemiologic findings. J Am Geriatr Soc. 1992 Feb;40(2):115–119. doi: 10.1111/j.1532-5415.1992.tb01929.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Grandien M., Pettersson C. A., Gardner P. S., Linde A., Stanton A. Rapid viral diagnosis of acute respiratory infections: comparison of enzyme-linked immunosorbent assay and the immunofluorescence technique for detection of viral antigens in nasopharyngeal secretions. J Clin Microbiol. 1985 Nov;22(5):757–760. doi: 10.1128/jcm.22.5.757-760.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Johnston S. L., Bloy H. Evaluation of a rapid enzyme immunoassay for detection of influenza A virus. J Clin Microbiol. 1993 Jan;31(1):142–143. doi: 10.1128/jcm.31.1.142-143.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Lui K. J., Kendal A. P. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985. Am J Public Health. 1987 Jun;77(6):712–716. doi: 10.2105/ajph.77.6.712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Matthey S., Nicholson D., Ruhs S., Alden B., Knock M., Schultz K., Schmuecker A. Rapid detection of respiratory viruses by shell vial culture and direct staining by using pooled and individual monoclonal antibodies. J Clin Microbiol. 1992 Mar;30(3):540–544. doi: 10.1128/jcm.30.3.540-544.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. McClure C. L. Common infections in the elderly. Am Fam Physician. 1992 Jun;45(6):2691–2698. [PubMed] [Google Scholar]
  9. Sorvillo F. J., Huie S. F., Strassburg M. A., Butsumyo A., Shandera W. X., Fannin S. L. An outbreak of respiratory syncytial virus pneumonia in a nursing home for the elderly. J Infect. 1984 Nov;9(3):252–256. doi: 10.1016/s0163-4453(84)90530-9. [DOI] [PubMed] [Google Scholar]
  10. Spada B., Biehler K., Chegas P., Kaye J., Riepenhoff-Talty M. Comparison of rapid immunofluorescence assay to cell culture isolation for the detection of influenza A and B viruses in nasopharyngeal secretions from infants and children. J Virol Methods. 1991 Aug;33(3):305–310. doi: 10.1016/0166-0934(91)90030-4. [DOI] [PubMed] [Google Scholar]
  11. Waner J. L., Todd S. J., Shalaby H., Murphy P., Wall L. V. Comparison of Directigen FLU-A with viral isolation and direct immunofluorescence for the rapid detection and identification of influenza A virus. J Clin Microbiol. 1991 Mar;29(3):479–482. doi: 10.1128/jcm.29.3.479-482.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Weingarten S., Riedinger M., Bolton L. B., Miles P., Ault M. Barriers to influenza vaccine acceptance. A survey of physicians and nurses. Am J Infect Control. 1989 Aug;17(4):202–207. doi: 10.1016/0196-6553(89)90129-6. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES