Evaluation of the fully automated AIX1000 rapid plasma reagin system compared to a manual plasma reagin testing method for the diagnosis of syphilis

Diagn Microbiol Infect Dis. 2020 Aug;97(4):115081. doi: 10.1016/j.diagmicrobio.2020.115081. Epub 2020 May 15.

Abstract

The analytical performance of the FDA-cleared AIX1000 automated RPR testing platform was evaluated in comparison to manual RPR card testing. Eight hundred thirty-three patient serum samples were analyzed, 87 samples were positive by the AIX1000, 108 were positive by the manual test method; overall agreement between methods was 96.5% (κ = 0.83). Cases were further classified by clinical and laboratory-based confirmation of disease, to which reactivity rates were compared, yielding sensitivities of 96.4% and 100%, and specificities of 99.2% and 96.8% for the automated and manual RPR methods, respectively. The difference in specificity between methods was statistically significant (P < 0.001). Twenty-five of 29 samples with discordant results were reactive by manual testing (titers of 1:1 or 1:2); 21 of 25 patients with negative AIX100 results were identified to have histories of remote, treated syphilis. Overall, the AIX1000 platform demonstrated excellent agreement with the manual RPR method; discrepancies occurred with specimens at the threshold of reactivity.

Keywords: AIX1000; Laboratory automation; RPR; Syphilis.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Algorithms
  • Antibodies, Bacterial / blood
  • Automation, Laboratory
  • Diagnostic Tests, Routine
  • Humans
  • Reagins / blood*
  • Sensitivity and Specificity
  • Syphilis / diagnosis*
  • Syphilis Serodiagnosis / methods*
  • Syphilis Serodiagnosis / standards
  • Treponema pallidum / immunology
  • Treponema pallidum / isolation & purification*

Substances

  • Antibodies, Bacterial
  • Reagins