Jane Kuypers1, Gregory Boughton2, Jina Chung2, Lindsay Hussey2, Meei-Li Huang3, Linda Cook3, Keith R Jerome3. 1. Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Electronic address: kuypers@uw.edu. 2. Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA. 3. Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA; Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Abstract
BACKGROUND: Rapid detection and differentiation of herpes simplex viruses (HSV) is important for patient management and treatment, especially in HSV meningoencephalitis. OBJECTIVES: Results of Simplexa HSV1 & 2 Direct kit (Focus Diagnostics), an FDA-cleared sample-to-result method providing results in ∼ 75 min, were compared to those of laboratory-developed real-time PCR assays (LDT) for detection of HSV1 and HSV2. STUDY DESIGN: Samples tested included 168 cerebral spinal fluid (CSF) collected prospectively and 150 tested retrospectively: 81 from clinical testing and 69 from subjects in a neonatal herpes study; and 53 plasma and sera. Each sample was tested by both methods on the same day. RESULTS: Three of 318 CSF had invalid Simplexa Direct results and negative LDT results. Three neonatal samples with low HSV viral loads by LDT could not be typed; two were HSV2 positive and one was negative by Simplexa Direct. Of 312 CSF with valid, type-specific results, HSV1 was detected in 16 by LDT and in 17 by Simplexa Direct; HSV2 was detected in 48 by LDT and in 49 by Simplexa Direct. Concordance rates were 98.4% (κ 0.84) and 97.1% (κ 0.89) for HSV1 and HSV2, respectively. Positive percent agreements were 87.5% for HSV1 and 91.7% for HSV2. Two and four CSF were positive only by LDT and three and five were positive only by Simplexa Direct for HSV1 and HSV2, respectively. CONCLUSIONS: Simplexa HSV1 & 2 assay performed well compared to an established LDT. The faster turn-around-time compared to LDT will allow for more rapid antiviral treatment and better patient management.
BACKGROUND: Rapid detection and differentiation of herpes simplex viruses (HSV) is important for patient management and treatment, especially in HSV meningoencephalitis. OBJECTIVES: Results of Simplexa HSV1 & 2 Direct kit (Focus Diagnostics), an FDA-cleared sample-to-result method providing results in ∼ 75 min, were compared to those of laboratory-developed real-time PCR assays (LDT) for detection of HSV1 and HSV2. STUDY DESIGN: Samples tested included 168 cerebral spinal fluid (CSF) collected prospectively and 150 tested retrospectively: 81 from clinical testing and 69 from subjects in a neonatal herpes study; and 53 plasma and sera. Each sample was tested by both methods on the same day. RESULTS: Three of 318 CSF had invalid Simplexa Direct results and negative LDT results. Three neonatal samples with low HSV viral loads by LDT could not be typed; two were HSV2 positive and one was negative by Simplexa Direct. Of 312 CSF with valid, type-specific results, HSV1 was detected in 16 by LDT and in 17 by Simplexa Direct; HSV2 was detected in 48 by LDT and in 49 by Simplexa Direct. Concordance rates were 98.4% (κ 0.84) and 97.1% (κ 0.89) for HSV1 and HSV2, respectively. Positive percent agreements were 87.5% for HSV1 and 91.7% for HSV2. Two and four CSF were positive only by LDT and three and five were positive only by Simplexa Direct for HSV1 and HSV2, respectively. CONCLUSIONS: Simplexa HSV1 & 2 assay performed well compared to an established LDT. The faster turn-around-time compared to LDT will allow for more rapid antiviral treatment and better patient management.
Authors: Andrea T Cruz; Stephen B Freedman; Dina M Kulik; Pamela J Okada; Alesia H Fleming; Rakesh D Mistry; Joanna E Thomson; David Schnadower; Joseph L Arms; Prashant Mahajan; Aris C Garro; Christopher M Pruitt; Fran Balamuth; Neil G Uspal; Paul L Aronson; Todd W Lyons; Amy D Thompson; Sarah J Curtis; Paul T Ishimine; Suzanne M Schmidt; Stuart A Bradin; Kendra L Grether-Jones; Aaron S Miller; Jeffrey Louie; Samir S Shah; Lise E Nigrovic Journal: Pediatrics Date: 2018-01-03 Impact factor: 7.124