Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Feb 22;56(3):e01531-17.
doi: 10.1128/JCM.01531-17. Print 2018 Mar.

The Drift in Molecular Testing for Influenza: Mutations Affecting Assay Performance

Kathleen A Stellrecht  1
Affiliations
Review

The Drift in Molecular Testing for Influenza: Mutations Affecting Assay Performance

Kathleen A Stellrecht. J Clin Microbiol. .

Abstract

Influenza is associated with rapid evolution due to lack of RNA polymerase proofreading, immunogenic selection, and frequent rearrangement of gene segments. Evolutionary changes affecting the performance of diagnostic testing have long been recognized. Hence, it is not surprising that such challenges apply to nucleic acid amplification tests, even though they are designed to target highly conserved regions. Initially, case reports involved single isolates of A(H1N1)pdm09. Over the past 4 years, subtype H3N2 viruses evolved to viral clades with mutations in the WHO-recommended target region, such that almost all isolates worldwide have significantly reduced sensitivities with many commercial reverse transcription-PCR tests.

Keywords: RT-PCR; clades; diagnostics; genetic drift; influenza.

PubMed Disclaimer

Figures

FIG 1
FIG 1
Ten-year history of annual trends in H3N2 clades and MP PCR target region patterns based on GISAID data (https://www.gisaid.org/). (A and B) Clade changes for (A) European and (B) USA 2014–2015 isolates along with the number of mutations observed in the MP PCR target region between nucleotides 144 and 251. (C and D) MP PCR target region pattern changes for (C) European and (D) USA isolates. Patterns are coded by letter based on Table 1 data.
See this image and copyright information in PMC

References

    1. Stellrecht KA. 2017. Molecular testing for respiratory viruses, p 123–137. In Coleman WB, Tsongalis GJ (ed), Diagnostic molecular pathology. Elsevier Inc, Amsterdam, the Netherlands.
    1. Merckx J, Wali R, Schiller I, Caya C, Gore GC, Chartrand C, Dendukuri N, Papenburg J. 5 September 2017. Diagnostic accuracy of novel and traditional rapid tests for influenza infection compared with reverse transcriptase polymerase chain reaction: a systematic review and meta-analysis. Ann Intern Med doi: 10.7326/M17-0848. - DOI - PubMed
    1. Kumar S, Henrickson KJ. 2012. Update on influenza diagnostics: lessons from the novel H1N1 influenza A pandemic. Clin Microbiol Rev 25:344–361. doi: 10.1128/CMR.05016-11. - DOI - PMC - PubMed
    1. Tong S, Li Y, Rivailler P, Conrardy C, Castillo DA, Chen LM, Recuenco S, Ellison JA, Davis CT, York IA, Turmelle AS, Moran D, Rogers S, Shi M, Tao Y, Weil MR, Tang K, Rowe LA, Sammons S, Xu X, Frace M, Lindblade KA, Cox NJ, Anderson LJ, Rupprecht CE, Donis RO. 2012. A distinct lineage of influenza A virus from bats. Proc Natl Acad Sci U S A 109:4269–4274. doi: 10.1073/pnas.1116200109. - DOI - PMC - PubMed
    1. Broberg E, Snacken R, Adlhoch C, Beauté J, Galinska M, Pereyaslov D, Brown C, Penttinen P; WHO European Region and the European Influenza Surveillance Network. 2015. Start of the 2014/15 influenza season in Europe: drifted influenza A(H3N2) viruses circulate as dominant subtype. Euro Surveill 20:21023. doi: 10.2807/1560-7917.ES2015.20.4.21023. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources