Detection of influenza A and B with the Alere ™ i Influenza A & B: a novel isothermal nucleic acid amplification assay

Influenza Other Respir Viruses. 2015 May;9(3):151-4. doi: 10.1111/irv.12303. Epub 2015 Feb 27.

Abstract

Background: Rapid influenza diagnostic tests (RIDTs) have an important role in clinical decision-making; however, the performances of currently available assays vary widely.

Objectives: We evaluated the performance of the Alere(™) i Influenza A&B (Alere(™) iNAT), a rapid isothermal nucleic acid amplification assay that has recently received FDA clearance, for the detection of influenza A and B viruses during the Australian influenza season of 2013. Results were compared to two other RIDTs tested in parallel; Quidel Sofia(®) Influenza A+B fluorescent immunoassay (FIA) and Alere(™) BinaxNOW(®) Influenza A & B immunochromatographic (ICT) assay.

Methods: A total of 202 paired nasopharyngeal swabs collected from patients ≥ 16 years old with an influenza-like illness (ILI) were eluted in 2 ml of universal transport medium (UTM) that was used to perform all three RIDTs in parallel. Reverse-transcription polymerase chain reaction (RT-PCR) was used as the reference standard.

Results: Compared to RT-PCR, Alere(™) iNAT detected 77.8% influenza A positive samples versus 71.4% and 44.4% for the Quidel Sofia(®) Influenza A+B FIA and BinaxNOW(®) Influenza A & B ICT assay, respectively. For influenza B, Alere(™) iNAT detected 75% of those positive by RT-PCR, versus 33.3% and 25.0% for Sofia(®) and BinaxNOW(®), respectively. The specificity of Alere(™) iNAT was 100% for influenza A and 99% for influenza B.

Conclusions: Alere(™) i Influenza A&B is a promising new rapid influenza diagnostic assay with potential point-of-care applications.

Keywords: Influenza; isothermal nucleic acid amplification; rapid diagnostic test(s); sensitivity; specificity.

MeSH terms

  • Adult
  • Australia
  • Chromatography, Affinity
  • Female
  • Humans
  • Influenza A virus / genetics
  • Influenza A virus / isolation & purification*
  • Influenza B virus / genetics
  • Influenza B virus / isolation & purification*
  • Influenza, Human / diagnosis*
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques*
  • Nucleic Acid Amplification Techniques*
  • Point-of-Care Systems
  • Reference Standards
  • Reverse Transcriptase Polymerase Chain Reaction
  • Seasons
  • Sensitivity and Specificity
  • Young Adult