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| |  Rapid Assay Highly Specific for Adenovirus Detection in Children: Presented at PAS By Jill Stein BALTIMORE, Md -- May 6, 2009 -- A new, rapid adenovirus antigen test shows excellent sensitivity for detecting adenovirus infection in paediatric patients, according to data released here at the Pediatric Academic Societies (PAS) Annual Meeting 2009. Investigators from Baylor College of Medicine, Houston, Texas, compared the use of a rapid adenovirus antigen test for detecting adenovirus infection with viral culture in clinical samples collected from paediatric patients. The results were presented here on May 3 by Faaria Ali, a medical student at Baylor. All patients had been evaluated for adenovirus infection at a tertiary-care children's hospital over a recent 2-year period. "While viral culture is a reliable method for adenovirus detection, it may take 2 to 14 days to grow," Ali pointed out. "Detection of adenovirus DNA using molecular methods requires expensive equipment and experienced personnel." The rapid adenovirus antigen test is a new, commercially available, immunochromatographic assay that uses paired adenovirus-specific monoclonal antibodies immobilised on a membrane. It provides results in less than 15 minutes. In the study, all samples submitted for rapid adenovirus testing were also cultured using standard viral-cell-culture technique and confirmed using immunofluoresence assay with virus-specific antibodies. The researchers calculated sensitivity, specificity, and predictive values with viral culture as the reference standard. Overall, 3,356 specimens were received (2,980 upper respiratory, 168 lower respiratory, 163 stool, 45 other), and 677 (20.2%) grew at least 1 virus. Adenovirus was isolated from 196 (5.8%). The rapid adenovirus test was positive in 107 (3.2%) specimens. Of the study population, 898 patients were from the emergency department, 1,116 from special-care units, 650 from immune-compromised units, 692 from a general-medicine ward. The new assay had a 33.7% sensitivity rate, a 98.7% specificity rate, a 61.7% positive predictive value, and a 96.0% negative predictive value. The investigators described the sensitivity rate as moderate to poor, and said that it varied by specimen type, patient age, and year of analysis. Ali concluded that the test was highly specific and provided reliable results that, if positive, were timely enough to potentially influence medical decision-making. He also noted that false-positive results may result from the presence of nonviable adenovirus or enteric adenovirus serotypes 40/41 not easily isolated in viral cultures. False-negative results may have occurred in response to low virus titre in samples or test methodology. Adenoviruses are a key cause of respiratory, ocular, gastrointestinal, and disseminated disease in healthy and immunocompromised infants and children.
[Presentation title: Performance of a New Immunochromatographic Assay for Rapid Detection of Adenovirus Infection in Children. Abstract 3867.272]
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