Clinical performance of the Xpert (R) Xpress Flu/RSV assay for the detection of influenza A, B, and respiratory syncytial virus on ESwab (TM) medium

Karin B. Gast, Angela C.I.M. Vrolijk, Anneke M.C. Bergmans, Tanja H. Geelen, Jan A.J.W. Kluytmans, Suzan D. Pas*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Prior to the SARS-CoV-2 pandemic, the Xpert® Xpress Flu/RSV assay (GXA) was regularly used, while during the pandemic the Xpert® Xpress SARS-CoV-2/Flu/RSV (plus) assay was developed by Cepheid. In contrast to this new assay, the use of oropharyngeal ESwabs in combination with the Flu/RSV assay is designated as off CE-IVD label use, while these were used frequently in The Netherlands. Aim: To investigate the clinical performance of the GXA using 1,289 ESwab™ oropharyngeal samples for the detection of Influenza A virus, Influenza B virus and respiratory syncytial virus (RSV). Methods: The clinical performance of the GXA was prospectively investigated during the influenza seasons of 2017 and 2018 by testing fresh oropharyngeal samples, collected with ESwab™, contemporaneously with both the GXA and a laboratory developed Flu/RSV real time RT-PCR assay (LDA) (reference method). Results: 1,289 Samples from 1,213 patients (46% men, median age 73 (IQR 62–82)) were tested with both tests. Positive percent agreement (95% CI) was 98% (95%-99%) for Influenza A virus, 92% (88%-95%) for influenza B virus, and 88% (73%-96%) for RSV. Negative percent agreement was ≥ 99% for all three viruses. Ct-values of the GXA were on average higher than the LDA. Conclusion: This study showed a good clinical performance of the GXA in oropharyngeal samples for the detection of Influenza A and B virus. The positive percent agreement of the GXA for the detection of RSV in oropharyngeal samples was somewhat lower and in particular for the detection of RSV-A.

Original languageEnglish
Article number100066
JournalJournal of Clinical Virology Plus
Volume2
Issue number1
DOIs
Publication statusPublished - Feb 2022
Externally publishedYes

Keywords

  • clinical performance
  • Influenza A virus
  • Influenza B virus
  • Rapid molecular testing
  • RSV

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