Reliable detection of respiratory syncytial virus infection in children for adequate hospital infection control management

By using a rapid test for respiratory syncytial virus (RSV) detection (Abbo tt TestPack RSV), a number of patients were observed, showing repeatedly po sitive results over a period of up to 10 weeks. A prospective study was ini tiated to compare the rapid test with an antigen capture enzyme immunoassay (EIA) and a nested reverse transcriptase PCR (RT-PCR) protocol for detecti on of RSV serotypes A and B. Only respiratory samples from children exhibit ing the prolonged presence of RSV (greater than or equal to5 days) as deter mined by the rapid test were considered. A total of 134 specimens from 24 c hildren was investigated by antigen capture EIA and nested RT-PCR. Using RT -PCR as the reference method, we determined the RSV rapid test to have a sp ecificity of 63% and a sensitivity of 66% and the antigen capture EIA to ha ve a specificity of 96% and a sensitivity of 69% for acute-phase samples an d the homologous virus serotype A. In 7 (29%) of 24 patients, the positive results of the RSV rapid test could not be confirmed by either nested RT-PC R or antigen capture EU. In these seven patients a variety of other respira tory viruses were detected. For general screening the RSV rapid test was fo und to be a reasonable tool to get quick results. However, its lack of spec ificity in some patients requires confirmation by additional tests to rule out false-positive results and/or detection of other respiratory viruses.