Abstract
Directigen FLU-A, an enzyme immunoassay membrane test, was compared prospectively to isolation in cell culture and direct immunofluorescence (IF) for the detection of influenza A virus. One hundred ninety specimens were evaluated by Directigen FLU-A and cell culture; 184 of these specimens were also tested by direct IF. The sensitivity of Directigen FLU-A compared to isolation in cell culture and direct IF was 100%. The specificities of Directigen FLU-A compared to isolation and direct IF were identical, 91.6%. Fourteen specimens that were positive by Directigen FLU-A did not yield virus in culture; two of the specimens, however, were positive by direct IF, and four other specimens were not specimens of choice for the test. A positive Directigen result had positive predictive values of 62.6 and 75.0% compared to isolation and direct IF, respectively; a positive Directigen result with an intensity reading of 2+ or greater, however, had positive predictive values of 85 and 100% compared to isolation and direct IF, respectively. In all comparisons, the negative predictive value was 100%. There was no evidence that cross-reactivity occurred with non-influenza A antigens. Directigen FLU-A should serve as a convenient screening test for influenza A and as a rapid test supported by isolation in cell culture during an influenza outbreak.
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- Daisy J. A., Lief F. S., Friedman H. M. Rapid diagnosis of influenza A infection by direct immunofluorescence of nasopharyngeal aspirates in adults. J Clin Microbiol. 1979 Jun;9(6):688–692. doi: 10.1128/jcm.9.6.688-692.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dolin R., Reichman R. C., Madore H. P., Maynard R., Linton P. N., Webber-Jones J. A controlled trial of amantadine and rimantadine in the prophylaxis of influenza A infection. N Engl J Med. 1982 Sep 2;307(10):580–584. doi: 10.1056/NEJM198209023071002. [DOI] [PubMed] [Google Scholar]
- Espy M. J., Smith T. F., Harmon M. W., Kendal A. P. Rapid detection of influenza virus by shell vial assay with monoclonal antibodies. J Clin Microbiol. 1986 Oct;24(4):677–679. doi: 10.1128/jcm.24.4.677-679.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Frank A. L., Couch R. B., Griffis C. A., Baxter B. D. Comparison of different tissue cultures for isolation and quantitation of influenza and parainfluenza viruses. J Clin Microbiol. 1979 Jul;10(1):32–36. doi: 10.1128/jcm.10.1.32-36.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Hall C. B., Dolin R., Gala C. L., Markovitz D. M., Zhang Y. Q., Madore P. H., Disney F. A., Talpey W. B., Green J. L., Francis A. B. Children with influenza A infection: treatment with rimantadine. Pediatrics. 1987 Aug;80(2):275–282. [PubMed] [Google Scholar]
- Harmon M. W., Pawlik K. M. Enzyme immunoassay for direct detection of influenza type A and adenovirus antigens in clinical specimens. J Clin Microbiol. 1982 Jan;15(1):5–11. doi: 10.1128/jcm.15.1.5-11.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LIU C. Rapid diagnosis of human influenza infection from nasal smears by means of fluorescein-labeled antibody. Proc Soc Exp Biol Med. 1956 Aug-Sep;92(4):883–887. doi: 10.3181/00379727-92-22642. [DOI] [PubMed] [Google Scholar]
- 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]
- McQuillin J., Madeley C. R., Kendal A. P. Monoclonal antibodies for the rapid diagnosis of influenza A and B virus infections by immunofluorescence. Lancet. 1985 Oct 26;2(8461):911–914. doi: 10.1016/s0140-6736(85)90849-9. [DOI] [PubMed] [Google Scholar]
- Minnich L. L., Ray C. G. Early testing of cell cultures for detection of hemadsorbing viruses. J Clin Microbiol. 1987 Feb;25(2):421–422. doi: 10.1128/jcm.25.2.421-422.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Monto A. S., Maassab H. F., Bryan E. R. Relative efficacy of embryonated eggs and cell culture for isolation of contemporary influenza viruses. J Clin Microbiol. 1981 Jan;13(1):233–235. doi: 10.1128/jcm.13.1.233-235.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sarkkinen H. K., Halonen P. E., Salmi A. A. Detection of influenza A virus by radioimmunoassay and enzyme-immunoassay from nasopharyngeal specimens. J Med Virol. 1981;7(3):213–220. doi: 10.1002/jmv.1890070305. [DOI] [PubMed] [Google Scholar]
- Schmidt N. J., Ota M., Gallo D., Fox V. L. Monoclonal antibodies for rapid, strain-specific identification of influenza virus isolates. J Clin Microbiol. 1982 Oct;16(4):763–765. doi: 10.1128/jcm.16.4.763-765.1982. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shalit I., McKee P. A., Beauchamp H., Waner J. L. Comparison of polyclonal antiserum versus monoclonal antibodies for the rapid diagnosis of influenza A virus infections by immunofluorescence in clinical specimens. J Clin Microbiol. 1985 Nov;22(5):877–879. doi: 10.1128/jcm.22.5.877-879.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stokes C. E., Bernstein J. M., Kyger S. A., Hayden F. G. Rapid diagnosis of influenza A and B by 24-h fluorescent focus assays. J Clin Microbiol. 1988 Jul;26(7):1263–1266. doi: 10.1128/jcm.26.7.1263-1266.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tominack R. L., Hayden F. G. Rimantadine hydrochloride and amantadine hydrochloride use in influenza A virus infections. Infect Dis Clin North Am. 1987 Jun;1(2):459–478. [PubMed] [Google Scholar]
- Walls H. H., Harmon M. W., Slagle J. J., Stocksdale C., Kendal A. P. Characterization and evaluation of monoclonal antibodies developed for typing influenza A and influenza B viruses. J Clin Microbiol. 1986 Feb;23(2):240–245. doi: 10.1128/jcm.23.2.240-245.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Waner J. L., Whitehurst N. J., Downs T., Graves D. G. Production of monoclonal antibodies against parainfluenza 3 virus and their use in diagnosis by immunofluorescence. J Clin Microbiol. 1985 Oct;22(4):535–538. doi: 10.1128/jcm.22.4.535-538.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Waner J. L., Whitehurst N. J., Jonas S., Wall L., Shalaby H. Isolation of viruses from specimens submitted for direct immunofluorescence test for respiratory syncytial virus. J Pediatr. 1986 Feb;108(2):249–250. doi: 10.1016/s0022-3476(86)80993-3. [DOI] [PubMed] [Google Scholar]
- Waner J. L., Whitehurst N. J., Todd S. J., Shalaby H., Wall L. V. Comparison of directigen RSV with viral isolation and direct immunofluorescence for the identification of respiratory syncytial virus. J Clin Microbiol. 1990 Mar;28(3):480–483. doi: 10.1128/jcm.28.3.480-483.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]