ENHANCED DETECTION OF MEASLES VIRUS INFECTION FOLLOWING SUCCESSFUL DEVELOPMENT OF A REAL-TIME REVERSE TRANSCRIPTASE PCR IN RESPIRATORY AND URINE SAMPLES USING THE CEPHEID SMARTCYCLER®. (February 2015)

• Record Type: Journal Article
• Authors: Chua, Kyra Y. L.; Thapa, Kiran; Yapa, Chaturangi M.; Somerville, Lucy K.; Sheppeard, Vicky; Chen, Sharon C-A.; Dwyer, Dominic E.; Kok, Jen
• Is Part Of: Pathology. Volume 47(2015)Supplement 1
• Publication Date: 2015-02
• Subjects: Pathology -- Periodicals; 616.0705
• DOI: 10.1097/01.PAT.0000461462.72644.2c
• Languages: English
• ISSNs: 0031-3025

Abstract

Abstract : Aims: Despite WHO-reported elimination of measles in Australia, importation of cases remains frequent. Laboratory confirmation supplements clinico-epidemiological evidence of measles virus infection, and is needed to establish elimination. Nucleic acid testing (NAT) using the SmartCycler ® platform for the detection of measles virus from combined nose and throat swabs (NTS), nasopharyngeal aspirates (NPA) and urine samples was developed. Methods: One hundred samples collected from patients with suspected measles were tested in parallel using immunofluorescence antigen (IFA) and NAT with SmartCycler ® and LightCycler ® RT-PCR platforms. Where available, the performance of measles virus-specific IgM and IgG serology was also assessed. Results: Using LightCycler ® RT-PCR as the reference standard, measles virus was detected in 35 clinical samples. There was 100% concordance between the results of the SmartCycler ® and the LightCycler ® -based RT-PCR. The sensitivity and specificity of IFA compared to NAT was 34.3% and 96.5%, respectively. Testing urine in addition to NTS or NPA did not improve diagnostic yield. Measles-specific IgM was detected in 15/21 (71.4%) patients with specimens that were measles NAT positive. Discussion: The performance of the SmartCycler ® is comparable to the LightCycler ® in the detection of measles virus. However, IFA had poor sensitivity and should not be used to confirm measles virus infection where NAT is available.