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Review
. 2021 Nov;27(11):2761-2767.
doi: 10.3201/eid2711.211449. Epub 2021 Sep 1.

Effectiveness of Abbott BinaxNOW Rapid Antigen Test for Detection of SARS-CoV-2 Infections in Outbreak among Horse Racetrack Workers, California, USA

Krishna Surasi, Kristin J Cummings, Carl Hanson, Mary Kate Morris, Maria Salas, David Seftel, Liza Ortiz, Ruwan Thilakaratne, Cameron Stainken, Debra A Wadford
Review

Effectiveness of Abbott BinaxNOW Rapid Antigen Test for Detection of SARS-CoV-2 Infections in Outbreak among Horse Racetrack Workers, California, USA

Krishna Surasi et al. Emerg Infect Dis. 2021 Nov.

Abstract

The Abbott BinaxNOW rapid antigen test is cheaper and faster than real-time reverse transcription PCR (rRT-PCR) for detecting severe acute respiratory syndrome coronavirus 2. We compared BinaxNOW with rRT-PCR in 769 paired specimens from 342 persons during a coronavirus disease outbreak among horse racetrack workers in California, USA. We found positive percent agreement was 43.3% (95% CI 34.6%-52.4%), negative percent agreement 100% (95% CI 99.4%-100%), positive predictive value 100% (95% CI 93.5%-100%), and negative predictive value 89.9% (95% CI 87.5%-92.0%). Among 127 rRT-PCR-positive specimens, the 55 with paired BinaxNOW-positive results had a lower mean cycle threshold than the 72 with paired BinaxNOW-negative results (17.8 vs. 28.5; p<0.001). Of 100 specimens with cycle threshold <30, a total of 51 resulted in positive virus isolation; 45 (88.2%) of those were BinaxNOW-positive. Our comparison supports immediate isolation for BinaxNOW-positive persons and confirmatory testing for negative persons.

Keywords: COVID-19; SARS-CoV-2; SARS-CoV-2 RT-PCR testing; SARS-CoV-2 antigen testing; coronavirus disease; disease outbreaks; respiratory infections; severe acute respiratory syndrome coronavirus 2; viruses; workplace; zoonoses.

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Figures

Figure 1
Figure 1
Concordance of BinaxNOW rapid antigen test results with positive rRT-PCR results over 6 testing rounds among staff at a horse racetrack, California, USA, November–December 2020. All rRT-PCR–negative results (n = 642) were concordant with BinaxNOW results, so only rRT-PCR–positive results (n = 127) are shown. Crossbars represent mean Ct for the concordant and discordant pair groups in each testing period. The dashed line represents Ct = 30. Ct, cycle threshold; rRT-PCR, real-time reverse transcription PCR.
Figure 2
Figure 2
BinaxNOW rapid antigen test results and viral culture results among 100 real-time reverse transcription PCR–positive specimens with cycle threshold <30 among staff at a horse racetrack, California, USA, November–December 2020. Of 51 viral culture–positive specimens, 45 were detected by BinaxNOW (88.2% concordance).
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References

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