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. 2021 Mar 19;59(4):e02965-20.
doi: 10.1128/JCM.02965-20. Print 2021 Mar 19.

Evaluation of the Xpert Xpress SARS-CoV-2/Flu/RSV Assay for Simultaneous Detection of SARS-CoV-2, Influenza A and B Viruses, and Respiratory Syncytial Virus in Nasopharyngeal Specimens

Eddie Chi-Man Leung  1 , Viola Chi-Ying Chow  2 , May Kin-Ping Lee  2 , Kevin Pui-San Tang  2 , Daniel Kwok-Cheung Li  2 , Raymond Wai-Man Lai  2
Affiliations

Evaluation of the Xpert Xpress SARS-CoV-2/Flu/RSV Assay for Simultaneous Detection of SARS-CoV-2, Influenza A and B Viruses, and Respiratory Syncytial Virus in Nasopharyngeal Specimens

Eddie Chi-Man Leung et al. J Clin Microbiol. .

Abstract

Patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A (flu A), influenza B (flu B), and respiratory syncytial virus (RSV) have overlapping clinical presentations, but the approaches to treatment and management of infections caused by these viruses are different. Therefore, rapid diagnosis in conjunction with infection prevention measures is important to prevent transmission of the diseases. Recently, a new Xpert Xpress SARS-CoV-2/Flu/RSV (Xpert 4-in-1) assay enables the detection and differentiation of SARS-CoV-2, flu A, flu B, and RSV in upper respiratory tract specimens. In this study, we evaluated the performance of the Xpert 4-in-1 assay by comparing it with that of the Xpert Xpress SARS-CoV-2 and Xpert Xpress Flu/RSV assays for the detection of the four viruses in nasopharyngeal (NP) specimens. A total of 279 NP specimens, including 66, 56, 64, and 53 specimens positive for SARS-CoV-2, flu A, flu B, and RSV, respectively, were included. The Xpert 4-in-1 assay demonstrated high concordance with the comparator assays, with overall agreement for SARS-CoV-2, flu A, flu B, and RSV at 99.64%, 100%, 99.64%, and 100%, respectively, and a high Cohen's kappa (κ) value ranging from 0.99 to 1.00, indicating an almost perfect correlation between assays. The cycle threshold value association between positive samples also showed a good correlation between assays. In conclusion, the overall performance of the Xpert 4-in-1 assay was highly comparable to that of the Xpert SARS-CoV-2 and Xpert Flu/RSV assays for the detection and differentiation of SARS CoV-2, flu A, flu B, and RSV in NP specimens.

Keywords: Xpert 4-in-1.

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Figures

FIG 1
FIG 1
Correlation between cycle threshold (CT) values of positive SARS-CoV-2 samples by the Xpert 4-in-1 and Xpert SARS-CoV-2 assays (n = 65).
FIG 2
FIG 2
Correlation between cycle threshold (CT) values of positive flu A samples by the Xpert 4-in-1 and Xpert Flu/RSV assays (n = 56).
FIG 3
FIG 3
Correlation between cycle threshold (CT) values of positive flu B samples by the Xpert 4-in-1 and Xpert Flu/RSV assays (n = 63).
FIG 4
FIG 4
Correlation between cycle threshold (CT) values of positive RSV samples by the Xpert 4-in-1 and Xpert Flu/RSV assays (n = 53).
See this image and copyright information in PMC

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