EVALUATION OF A RAPID DIAGNOSTIC-TEST FOR RESPIRATORY SYNCYTIAL VIRUS(RSV) - POTENTIAL FOR BEDSIDE DIAGNOSIS

Objective. Rapid detection of respiratory syncytial virus (RSV) infect ion can assist clinicians in decisions regarding antiviral therapy wit h ribavirin as well as instituting infection control measures. The Abb ott TestPack RSV is a rapid RSV detection immunoassay that can be perf ormed on respiratory secretions in 20 to 30 minutes without special la boratory equipment. The purpose of this study was to evaluate housesta ff performance of the TestPack RSV at bedside as compared with laborat ory testing of aliquots of the same specimen by tissue culture inocula tion, direct fluorescent antibody (DFA) testing, and TestPack RSV. Met hods. During the 1991 through 1992 RSV season, 137 nasopharyngeal aspi rates or washes obtained from pediatric patients <4 years of age suffe ring from acute respiratory disease were assayed by the Food and Drug Administration-approved TestPack RSV as well as conventional tube cult ure and DFA testing. Results. 66 of 137 (48%) specimens were positive for RSV as defined by: isolation and DFA-positive (n = 48) and DFA tes ting positive with negative culture (n = 18); blocking assay experimen ts using TestPack RSV confirmed culture-negative DFA-positive specimen s as positive in 8/8 instances in which material for retesting was ava ilable. Using these definitions, the sensitivity and specificity for t he assays were: housestaff TestPack RSV: 92%, 93%; laboratory TestPack RSV: 97%, 98%; virus isolation: 72%, 100%. Conclusion. From these dat a, it appears that the TestPack RSV EIA in the field setting is reliab le, although laboratory confirmation of results is important.