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Point of Care Testing: Diagnosis Outside the Virology Laboratory

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Diagnostic Virology Protocols

Part of the book series: Methods in Molecular Biology ((MIMB,volume 665))

Abstract

Numerous point-of-care tests (POCTs) are available to diagnose viral infections in both hospital and community settings. The ideal POCT is rapid, sensitive, specific, and simple to perform. This chapter will describe the benefits of POCTs, factors that can influence the accuracy of POCTs and highlight some limitations of POCT strategies. The sensitivity, specificity, and turn-around time of available POCTs are included for common conditions including respiratory viral infections (e.g. influenza, RSV) and blood-borne viral infections (e.g. HIV).

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References

  1. Cramb, R. (2004) Guidelines of point-of-care testing. The Royal College of Pathologists. Accessed December 10, 2008, at http://www.rcpath.org/resources/pdf/Point-of-CareTesting-updatedOct04.pdf.

  2. Price, C.P., St John, A., and Hicks, J.M. (2004) Point-of-care testing: what, why, when and where? In: Price, C.P., St John, A., and Hicks, J.M. Eds. Point-of-Care Testing. AACC, Washington, DC, pp. 3–12.

    Google Scholar 

  3. Dwyer, D.E. and Sintchenko, V. (2007) Point-of-care testing for community-acquired pneumonia: do we have all the answers? Med J Aust 187(1), 40–42.

    PubMed  Google Scholar 

  4. Carpenter, A.B. (2007) Immunoassays for diagnosis of infectious diseases. In: Murray, P.R. Ed. Manual of Clinical Microbiology, 9th Edn. ASM, Washington, DC, pp. 257–271.

    Google Scholar 

  5. Information on CLIA Waivers: U.S. Food and Drug Administration (2008) Department of Health and Human Services. US Food and Drug Administration, Silver Spring, MD. Accessed December 10, 2008, at http://www.fda.gov/cdrh/cliawaived.html.

  6. Point of Care Testing Position Statement. (2007) Australasian Association of Clinical Biochemists. Accessed December 10, 2008, at http://www.aacb.asn.au/admin/?getfile=691.

  7. Boran, G., Collier, J., Hurley, T., Grimes O’Cearbhaill, H., McCarroll, N., Guerin, J., et al. (2007) Guidelines for Safe and Effective Management and Use of Point of Care Testing. Academy of Medical Laboratory Science, Association of Clinical Biochemists in Ireland, Irish Medicines Board and RCPI Faculty of Pathology, Ireland.

    Google Scholar 

  8. Bonner, A.B., Monroe, K.W., Talley, L.I., Klasner, A.E., and Kimberlin, D.W. (2003) Impact of the rapid diagnosis of influenza on physician decision-making and patient management in the pediatric emergency department: results of a randomized, prospective, controlled trial. Pediatrics 112(2), 363–367.

    Article  PubMed  Google Scholar 

  9. Woo, P.C., Chiu, S.S., Seto, W.H., and Peiris, M. (1997) Cost-effectiveness of rapid diagnosis of viral respiratory tract infections in pediatric patients. J Clin Microbiol 35(6), 1579–1581.

    PubMed  CAS  Google Scholar 

  10. Kassler, W.J., Dillon, B.A., Haley, C., Jones, W.K., and Goldman, A. (1997) On-site, rapid HIV testing with same-day results and counseling. AIDS 11(8), 1045–1051.

    Article  PubMed  CAS  Google Scholar 

  11. Iyer, S.B., Gerber, M.A., Pomerantz, W.J., Mortensen, J.E., and Ruddy, R.M. (2006) Effect of point-of-care influenza testing on management of febrile children. Acad Emerg Med 13(12), 1259–1268.

    Article  PubMed  Google Scholar 

  12. Charles, P.G., Whitby, M., Fuller, A.J., Stirling, R., Wright, A.A., Korman, T.M., et al. (2008) The etiology of community-acquired pneumonia in Australia: why penicillin plus doxycycline or a macrolide is the most appropriate therapy. Clin Infect Dis 46(10), 1513–1521.

    Article  PubMed  CAS  Google Scholar 

  13. Charles, P.G. and Grayson, M.L. (2007) Point-of-care tests for lower respiratory tract infections. Med J Aust 187(1), 36–39.

    PubMed  Google Scholar 

  14. Atmar RL. (2007) Influenza viruses. In: Murray, P.R. Ed. Manual of Clinical Microbiology, 9th Edn. ASM, Washington, DC, pp. 1340–1351.

    Google Scholar 

  15. World Health Organisation (2008) Influenza A(H1N1) Virus Resistance to Oseltamivir – 2008 Influenza Season, Southern Hemisphere. WHO, Geneva. Accessed December 10, 2008, at http://www.who.int/csr/disease/influenza/H1N1200801013.pdf.

  16. Beigel, J.H., Farrar, J., Han, A.M., Hayden, F.G., Hyer, R., de Jong, M.D., et al. (2005) Avian influenza A (H5N1) infection in humans. N Engl J Med 353(13), 1374–1385.

    Article  PubMed  Google Scholar 

  17. Chan, K.H., Lam, S.Y., Puthavathana, P., Nguyen, T.D., Long, H.T., Pang, C.M., et al. (2007) Comparative analytical sensitivities of six rapid influenza A antigen detection test kits for detection of influenza A subtypes H1N1, H3N2 and H5N1. J Clin Virol 38(2), 169–171.

    Article  PubMed  CAS  Google Scholar 

  18. Ruest, A., Michaud, S., Deslandes, S., and Frost, E.H. (2003) Comparison of the Directigen flu A + B test, the QuickVue influenza test, and clinical case definition to viral culture and reverse transcription-PCR for rapid diagnosis of influenza virus infection. J Clin Microbiol 41(8), 3487–3493.

    Article  PubMed  CAS  Google Scholar 

  19. Rawlinson, W.D., Waliuzzaman, Z.M., Fennell, M., Appleman, J.R., Shimasaki, C.D., and Carter, I.W. (2004) New point of care test is highly specific but less sensitive for influenza virus A and B in children and adults. J Med Virol 74(1), 127–131.

    Article  PubMed  Google Scholar 

  20. Bellei, N., Benfica, D., Perosa, A.H., Carlucci, R., Barros, M., and Granato, C. (2003) Evaluation of a rapid test (QuickVue) compared with the shell vial assay for detection of influenza virus clearance after antiviral treatment. J Virol Methods 109(1), 85–88.

    Article  PubMed  CAS  Google Scholar 

  21. Hayden, F.G., Treanor, J.J., Fritz, R.S., Lobo, M., Betts, R.F., Miller, M., et al. (1999) Use of the oral neuraminidase inhibitor oseltamivir in experimental human influenza: randomized controlled trials for prevention and treatment. JAMA 282(13), 1240–1246.

    Article  PubMed  CAS  Google Scholar 

  22. Ison, M.G. and Hayden, F.G. (2001) Therapeutic options for the management of influenza. Curr Opin Pharmacol 1(5), 482–490.

    Article  PubMed  CAS  Google Scholar 

  23. Church, D.L., Davies, H.D., Mitton, C., Semeniuk, H., Logue, M., Maxwell, C., et al. (2002) Clinical and economic evaluation of rapid influenza a virus testing in nursing homes in Calgary, Canada. Clin Infect Dis 34(6), 790–795.

    Article  PubMed  Google Scholar 

  24. Tang, Y.W. and Crowe, J.E.J. (2000) Respiratory syncytial virus and human metapneumovirus. In: Murray, P.R. Ed. Manual of Clinical Microbiology, 9th Edn. ASM, Washington, DC, pp. 257–271.

    Google Scholar 

  25. Casiano-Colon, A.E., Hulbert, B.B., Mayer, T.K., Walsh, E.E., and Falsey, A.R. (2003) Lack of sensitivity of rapid antigen tests for the diagnosis of respiratory syncytial virus infection in adults. J Clin Virol 28(2), 169–174.

    Article  PubMed  CAS  Google Scholar 

  26. Ohm-Smith, M.J., Nassos, P.S., and Haller, B.L. (2004) Evaluation of the Binax NOW, BD Directigen, and BD Directigen EZ assays for detection of respiratory syncytial virus. J Clin Microbiol 42(7), 2996–2999.

    Article  PubMed  CAS  Google Scholar 

  27. Mackie, P.L., Joannidis, P.A., and Beattie, J. (2001) Evaluation of an acute point-of-care system screening for respiratory syncytial virus infection. J Hosp Infect 48(1), 66–71.

    Article  PubMed  CAS  Google Scholar 

  28. Centers for Disease Control and Prevention. (2003) Advancing HIV prevention: new strategies for a changing epidemic – United States, 2003. MMWR Morb Mortal Wkly Rep 52, 329–332.

    Google Scholar 

  29. Sullivan, P.S., Lansky, A., and Drake, A. (2004) Failure to return for HIV test results among persons at high risk for HIV infection: results from a multistate interview project. J Acquir Immune Defic Syndr 35(5), 511–518.

    Article  PubMed  Google Scholar 

  30. World Health Organisation (2002) HIV Assays: Operational Characteristics (Phase I). Report 13: Urine Specimens, Oral Fluid (Saliva) Specimens. WHO, Geneva. Accessed December 10, 2008, at http://www.who.int/diagnostics_laboratory/publications/hiv_assays_rep_12.pdf.

  31. World Health Organisation (2002) HIV Assays: Operational Characteristics (Phase I). Report 12: Simple/Rapid Tests, Whole Blood Specimen. WHO, Geneva. Accessed December 10, 2008, at http://www.who.int/diagnostics_laboratory/publications/hiv_assays_rep_12.pdf.

  32. Centers for Disease Control and Prevention (2008) FDA-Approved Rapid HIV Antibody Screening Tests. Accessed December 10, 2008, at http://www.cdc.gov/hiv/topics/testing/rapid/rt-comparison.htm.

  33. World Health Organisation (2004) HIV Assays: Operational Characteristics (Phase I). Report 14: Simple/Rapid Tests. WHO, Geneva. Accessed December 10, 2008, at http://www.who.int/diagnostics_laboratory/publications/hiv_assays_rep_12.pdf.

  34. Branson, B.M. (2003) Point-of-care rapid tests for HIV antibodies. J Lab Med 27(7/8), 288–295.

    Article  Google Scholar 

  35. Constantine, N.T., Zekeng, L., Sangare, A.K., Gurtler, L., Saville, R., Anhary, H., et al. (1997) Diagnostic challenges for rapid human immunodeficiency virus assays. Performance using HIV-1 group O, HIV-1 group M, and HIV-2 samples. J Hum Virol 1(1), 45–51.

    PubMed  CAS  Google Scholar 

  36. Makuwa, M., Souquiere, S., Niangui, M.T., Rouquet, P., Apetrei, C., Roques, P., et al. (2002) Reliability of rapid diagnostic tests for HIV variant infection. J Virol Methods 103(2), 183–190.

    Article  PubMed  CAS  Google Scholar 

  37. Phillips, S., Granade, T.C., Pau, C.P., Candal, D., Hu, D.J., and Parekh, B.S. (2000) Diagnosis of human immunodeficiency virus type 1 infection with different subtypes using rapid tests. Clin Diagn Lab Immunol 7(4), 698–699.

    PubMed  CAS  Google Scholar 

  38. Reynolds, S.J., Ndongala, L.M., Luo, C.C., Mwandagalirwa, K., Losoma, A.J., Mwamba, K.J., et al. (2002) Evaluation of a rapid test for the detection of antibodies to human immunodeficiency virus type 1 and 2 in the setting of multiple transmitted viral subtypes. Int J STD AIDS 13(3), 171–173.

    Article  PubMed  Google Scholar 

  39. Spielberg, F., Branson, B.M., Goldbaum, G.M., Lockhart, D., Kurth, A., Rossini, A., et al. (2005) Choosing HIV counseling and testing strategies for outreach settings: a randomized trial. J Acquir Immune Defic Syndr 38(3), 348–355.

    PubMed  Google Scholar 

  40. Spielberg, F., Branson, B.M., Goldbaum, G.M., Lockhart, D., Kurth, A., Celum, C.L., et al. (2003) Overcoming barriers to HIV testing: preferences for new strategies among clients of a needle exchange, a sexually transmitted disease clinic, and sex venues for men who have sex with men. J Acquir Immune Defic Syndr 32(3), 318–327.

    Article  PubMed  Google Scholar 

  41. Chalermchockcharoenkit, A., Louisirirotch­nakul, S., Roongpisuthipong, A., Sirimai, K., Sutchritpongsa, P., and Wasi, C. (2002) Rapid human immunodeficiency virus diagnostic test during the intrapartum period in pregnant women who did not receive antenatal care. J Med Assoc Thai 85(6), 703–708.

    PubMed  Google Scholar 

  42. Volmink, J., Siegfried, N.L., van der Merwe, L., and Brocklehurst, P. (2008) Antiretrovirals for reducing the risk of mother-to-child transmission of HIV infection (Review). Cochrane Collab 8, 3.

    Google Scholar 

  43. Pai, N.P., Tulsky, J.P., Cohan, D., Colford, J.M. Jr., and Reingold, A.L. (2007) Rapid point-of-care HIV testing in pregnant women: a systematic review and meta-analysis. Trop Med Int Health 12(2), 162–173.

    Article  PubMed  Google Scholar 

  44. Long, S, Ed. (2006) Red Book: Report of the Committee on Infectious Diseases, 27th Edn. American Academy of Pediatrics, Elk Grove Village, IL.

    Google Scholar 

  45. Department of Health and Aging. (2008) The Australian Immunisation Handbook, 9th Edn. Department of Health and Aging, Australia.

    Google Scholar 

  46. Lau, D.T., Ma, H., Lemon, S.M., Doo, E., Ghany, M.G., Miskovsky, E., et al. (2003) A rapid immunochromatographic assay for hepatitis B virus screening. J Viral Hepat 10(4), 331–334.

    Article  PubMed  Google Scholar 

  47. Dennehy, P.H., Hartin, M., Nelson, S.M., and Reising, S.F. (1999) Evaluation of the ImmunoCardSTAT! rotavirus assay for detection of group A rotavirus in fecal specimens. J Clin Microbiol 37(6), 1977–1979.

    PubMed  CAS  Google Scholar 

  48. Anderson, D.A. (2000) Waterborne hepatitis. In: Spector, S.C., Hodinka, R.L., and Young, S.A. Eds. Clinical Virology Manual. ASM, Washington, DC.

    Google Scholar 

  49. Chen, H.Y., Lu, Y., Howard, T., Anderson, D., Fong, P.Y., Hu, W.P., et al. (2005) Comparison of a new immunochromatographic test to enzyme-linked immunosorbent assay for rapid detection of immunoglobulin M antibodies to hepatitis E virus in human sera. Clin Diagn Lab Immunol 12(5), 593–598.

    PubMed  CAS  Google Scholar 

  50. Myint, K.S., Guan, M., Chen, H.Y., Lu, Y., Anderson, D., Howard, T., et al. (2005) Evaluation of a new rapid immunochromatographic assay for serodiagnosis of acute hepatitis E infection. Am J Trop Med Hyg 73(5), 942–946.

    PubMed  CAS  Google Scholar 

  51. Fujimoto, T., Okafuji, T., Ito, M., Nukuzuma, S., Chikahira, M., and Nishio, O. (2004) Evaluation of a bedside immunochromatographic test for detection of adenovirus in respiratory samples, by comparison to virus isolation, PCR, and real-time PCR. J Clin Microbiol 42(12), 5489–5492.

    Article  PubMed  CAS  Google Scholar 

  52. Ouchi, K., Hasegawa, K., Nonaka, Y., Matsushima, H., Komura, H., Maki, T., et al. (1999) Rapid diagnosis of adenovirus respiratory tract infections by immunochromatography. J Infect Chemother 5(4), 220–222.

    Article  PubMed  CAS  Google Scholar 

  53. Tsutsumi, H., Ouchi, K., Ohsaki, M., Yamanaka, T., Kuniya, Y., Takeuchi, Y., et al. (1999) Immunochromatography test for rapid diagnosis of adenovirus respiratory tract infections: comparison with virus isolation in tissue culture. J Clin Microbiol 37(6), 2007–2009.

    PubMed  CAS  Google Scholar 

  54. Mielke, J., Grub, M., Freudenthaler, N., Deuter, C.M., Beck, R., and Zierhut, M. (2005) [Epidemic keratoconjunctivitis. Detecting adenoviruses]. Ophthalmologe (German) 102(10), 968–970.

    Article  CAS  Google Scholar 

  55. Sambursky, R., Tauber, S., Schirra, F., Kozich, K., Davidson, R., and Cohen, E.J. (2006) The RPS adeno detector for diagnosing adenoviral conjunctivitis. Ophthalmology 113(10), 1758–1764.

    Article  PubMed  Google Scholar 

  56. Uchio, E., Aoki, K., Saitoh, W., Itoh, N., and Ohno, S. (1997) Rapid diagnosis of adenoviral conjunctivitis on conjunctival swabs by 10-minute immunochromatography. Ophthal­mology 104(8), 1294–1299.

    PubMed  CAS  Google Scholar 

  57. Udeh, B.L., Schneider, J.E., and Ohsfeldt, R.L. (2008) Cost effectiveness of a point-of-care test for adenoviral conjunctivitis. Am J Med Sci 336(3), 254–264.

    Article  PubMed  Google Scholar 

  58. Philip, S.S., Ahrens, K., Shayevich, C., de la Roca, R., Williams, M., Wilson, D., et al. (2008) Evaluation of a new point-of-care serologic assay for herpes simplex virus type 2 infection. Clin Infect Dis 47(10), e79–e82.

    Article  PubMed  Google Scholar 

  59. Hurt, C. and Tammaro, D. (2007) Diagnostic evaluation of mononucleosis-like illnesses. Am J Med 120, 911.e1–911.e8.

    PubMed  Google Scholar 

  60. Bruu, A.L., Hjetland, R., Holter, E., Mortensen, L., Natas, O., Petterson, W., et al. (2000) Evaluation of 12 commercial tests for detection of Epstein-Barr virus-specific and heterophile antibodies. Clin Diagn Lab Immunol 7(3), 451–456.

    PubMed  CAS  Google Scholar 

  61. Elgh, F. and Linderholm, M. (1996) Evaluation of six commercially available kits using purified heterophile antigen for the rapid diagnosis of infectious mononucleosis compared with Epstein-Barr virus-specific serology. Clin Diagn Virol 7(1), 17–21.

    Article  PubMed  CAS  Google Scholar 

  62. Gerber, M.A., Shapiro, E.D., Ryan, R.W., and Bell, G.L. (1996) Evaluations of enzyme-linked immunosorbent assay procedure for determining specific Epstein-Barr virus serology and of rapid test kits for diagnosis for infectious mononucleosis. J Clin Microbiol 34(12), 3240–3241.

    PubMed  CAS  Google Scholar 

  63. Linderholm, M., Boman, J., Juto, P., and Linde, A. (1994) Comparative evaluation of nine kits for rapid diagnosis of infectious mononucleosis and Epstein-Barr virus-specific serology. J Clin Microbiol 32(1), 259–261.

    PubMed  CAS  Google Scholar 

  64. Al-Jitawi, S.A., Hakooz, B.A., and Kazimi, S.M. (1987) False positive monospot test in systemic lupus erythematosus. Br J Rheumatol 26(1), 71.

    Article  PubMed  CAS  Google Scholar 

  65. Vidrih, J.A., Walensky, R.P., Sax, P.E., and Freedberg, K.A. (2001) Positive Epstein-Barr virus heterophile antibody tests in patients with primary human immunodeficiency virus infection. Am J Med 111(3), 192–194.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Centre for Infectious Diseases and Microbiology Laboratory Services, Westmead Hospital, Sydney, NSW, Australia

    Christopher C. Blyth & Dominic E. Dwyer

  2. National Centre of Immunisation Research and Surveillance of Vaccine Preventable Disease, The Children’s Hospital at Westmead and The University of Sydney, Sydney, NSW, Australia

    Robert Booy

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  1. Christopher C. Blyth
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  2. Robert Booy
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  3. Dominic E. Dwyer
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Editors and Affiliations

  1. , Research & Development Division, Health Protection Agency, High Holborn 330, London, WC1V 7BA, United Kingdom

    John R. Stephenson

  2. Northwick Park Hospital, Research and Development, North West London Hospitals NHS Trust, Watford Road, Harrow, HA13UJ, Middlesex, United Kingdom

    Alan Warnes

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Blyth, C.C., Booy, R., Dwyer, D.E. (2010). Point of Care Testing: Diagnosis Outside the Virology Laboratory. In: Stephenson, J., Warnes, A. (eds) Diagnostic Virology Protocols. Methods in Molecular Biology, vol 665. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-817-1_22

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  • DOI: https://doi.org/10.1007/978-1-60761-817-1_22

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