ILI in this study was defined as fever (≥ 38°C), with or without respiratory symptoms, lacking an identifiable cause other than influenza. Laboratory-confirmed influenza illness was defined as positive RAT (lateral flow immunoassay, BD Directigen™ EZ Flu A+B; Becton Dickinson, Franklin Lakes, NJ, USA) or positive multiplex PCR (AdvanSure™ RV real-time reverse transcription-PCR; LG Life Sciences, Seoul, Korea). LRTI was defined as the need for oxygen supplementation due to hypoxia (SpO2 < 95%) or pneumonic infiltrations on chest radiograph (lobar consolidation, pleural effusion, acute respiratory distress syndrome, etc.). LRTI was further specified as severe if oxygen supplementation was required for ≥ 24 hours. Severe influenza infection was defined as cases of severe LRTI, or upper respiratory tract infection (URTI) upon ED presentation that progressed to LRTI during the hospitalization. The turnaround time to antiviral treatment (TAT) was defined as the time when the clinician ordered the RAT to when oral oseltamivir or intravenous peramivir was administered to the patient. LRTI, severe LRTI, progression from URTI to LRTI, severe influenza, pediatric intensive care unit (PICU) admission, mechanical ventilation, and 30-day mortality were used as clinical outcome parameters.
Directigen ez flu a b
Manufactured by BD
Sourced in United States
The BD Directigen™ EZ Flu A+B is a rapid qualitative test that detects and differentiates influenza A and B viral antigens from nasal swab specimens.
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Lab products found in correlation
4 protocols using directigen ez flu a b
1
Influenza Severity and Outcomes
2
Rapid Antigen and PCR Testing for Influenza
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Different rapid antigen detection kits were used across the different seasons. These included: Rapid FLU virus test kit Capilia™ Tauns, Japan; Quick-Ex flu A/B rapid influenza test Denka Seiken, Japan; Quick-Ex flu A/B & RSV rapid influenza test Denka Seiken, Japan; and BD Directigen™ EZ Flu A + B (Becton Dickinson, Cockeysville, Md.). Testing was performed following the manufacturer’s instructions.
Polymerase chain reaction: real-time reverse-transcriptase (RT) polymerase chain reaction (PCR) using the GENEXPERT (Cepheid) platform was used at AUBMC Clinical Molecular Biology Laboratory [33 (link)].
Only 2 patients were diagnosed by serology testing (Influenza A IgG titers cutoff < 1:10, our patients had a titer level of 1:5120). This was during the 2009 influenza pandemic.
3
Detecting Influenza A Virus in Eggs
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Each CS, FS, and TS (individual or pooled) was injected into the allantoic cavity of 10‐day‐old embryonated chicken eggs and tested for the presence of IAV in hemagglutination assays13 by using 1% chicken erythrocytes and the Directigen™ EZ Flu A+B (Becton Dickinson, Franklin Lakes, NJ, USA) rapid test.
4
Influenza Case Confirmation Protocol
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The laboratory confirmation of influenza cases was performed twice. First, 1 of the 2 samples collected for each patient was tested in the investigator's office for the presence of influenza virus using a commercially available rapid diagnostic kit able to distinguish influenza A and B (16 17 18 ). The SAS FluAlert (SA Scientific, San Antonio, TX, USA) (16 ) was used for the 2007–2008 season and the BinaxNOW Influenza A & B Test (Inverness Medical Innovations, Inc., Livermore, CA, USA) (17 ) or Directigen EZ Flu A + B (Becton, Dickinson and Company, Franklin Lakes, NJ, USA) (18 ) were used for the 2008–2009 season. The second sample was sent to the Korea University Guro Hospital for identification and typing by culture (for both seasons) and reverse transcriptase polymerase chain reaction (RT-PCR; capillary electrophoresis-based multiplex RT-PCR assay using the Seeplex Respiratory Pathogen 18-plex Test [Seegene, Seoul, Korea]) (19 (link)); only during the second season according to local standard operating procedures.
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