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Evaluation of respiratory syncytial virus detection by rapid antigen tests in childhood
U Schauer1, G Ihorst, A Rohwedder
1St. Josef Hospital, Klinik für Kinder- und Jugendmedizin, Ruhr-Universität Bochum. Uwe.Schauer@ruhr-uni-bochum.de
Insights
Rapid antigen tests for respiratory syncytial virus (RSV) are useful for diagnosing RSV infection in young infants. However, their sensitivity decreases in children older than three months.
Area of Science:
- Pediatric infectious diseases
- Diagnostic microbiology
- Respiratory viral infections
Background:
- Accurate diagnosis of respiratory syncytial virus (RSV) infection is vital for effective pediatric care.
- This study evaluated the performance of rapid antigen immunoassays for RSV in hospitalized children.
Purpose of the Study:
- To assess the diagnostic accuracy of rapid antigen detection tests for RSV in children.
- To identify factors influencing the performance of these tests.
Main Methods:
- 1600 children hospitalized with potential RSV disease were enrolled.
- Nasopharyngeal secretions were tested using PCR (gold standard) and rapid antigen tests.
- Clinical and demographic data were collected.
Main Results:
- Rapid antigen tests showed 89.9% specificity and 66.2% sensitivity against PCR.
- Sensitivity was influenced by age and recruitment center, but specificity was not.
- Diagnostic utility varied by age, with higher positive likelihood ratios in younger children.
Conclusions:
- Rapid RSV antigen tests are valuable for diagnosing RSV in infants.
- Test sensitivity declines in children over three months of age.
- Age is a significant factor affecting the reliability of rapid RSV antigen detection.
Background:
Rapid and reliable diagnosis is crucial for clinical management of respiratory syncytial virus infection in childhood. We assessed the performance characteristics of respiratory syncytial virus antigen immunoassays in children hospitalized for respiratory infection.
Method:
A total of 1600 children up to three years of age hospitalized for diseases potentially caused by RSV were included in the study. Nasopharyngeal secretions were obtained in a standardized manner in the first 24 hours after hospital admission and tested in parallel by PCR and rapid antigen tests for RSV. The following parameters were recorded: recruitment center, gender, age, presence of fever, rhinitis, stridor, barking cough, cough, wheezing, vomiting, disturbed eating or sleep, tachypnea, tachycardia, increased body temperature, decreased oxygen saturation, C-reactive protein, erythrocyte sedimentation rate and chest X-ray results.
Results:
Considering PCR testing as gold standard, rapid antigen testing had a specificity of 89.9% and a sensitivity of 66.2% for all samples tested. Logistic regression analysis revealed age and recruitment center as the only parameters influencing sensitivity whereas no such influence on specificity was found. Positive likelihood ratios ranged from 4,9 to 6.9 in different age groups. Negative likelihood ratio was 0.24 (95% CI: 0.18-0.42) in children aged up to 3 months but 0.67 (95% CI: 0.53-0.84) for children older than 2 years.
Conclusion:
Rapid detection of RSV antigen in this study was useful in detection of RSV mediated disease in younger infants but shows decreasing sensitivity in children older than three months.
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