%0 Journal Article %A Ganzenmueller, Tina %A Kluba, Jeanette %A Hilfrich, Birgit %A Puppe, Wolfram %A Verhagen, Willem %A Heim, Albert %A Schulz, Thomas %A Henke-Gendo, Cornelia %T Comparison of the performance of direct fluorescent antibody staining, a point-of-care rapid antigen test and virus isolation with that of RT-PCR for the detection of novel 2009 influenza A (H1N1) virus in respiratory specimens %D 2010 %J Journal of Medical Microbiology, %V 59 %N 6 %P 713-717 %@ 1473-5644 %R https://doi.org/10.1099/jmm.0.017244-0 %K NPV, negative predictive value %K Ct, threshold cycle %K PPV, positive predictive value %K POC, point of care %K MDCK, Madin–Darby canine kidney %K DFA, direct fluorescent antibody %I Microbiology Society, %X Although infections with the novel pandemic 2009 influenza A (H1N1) virus (A/H1N1/2009) appeared to be relatively mild during the first summer of circulation (‘off season’), there has been significant morbidity and hospitalization and several fatal cases. Thus, rapid detection of A/H1N1/2009 is crucial for efficient treatment and infection control measures. In contrast to seasonal influenza, where point-of-care (POC) rapid antigen tests and direct fluorescent antibody (DFA) staining ensure rapid detection, diagnosis of A/H1N1/2009 has so far been based on RT-PCR. This study retrospectively compared the performance of the Quidel QuickVue POC test, DFA staining and virus isolation with that of RT-PCR for A/H1N1/2009 detection in 526 respiratory specimens collected during the first wave of the outbreak from May to September 2009. A/H1N1/2009 was detected in 9.1 % (48/526) of samples. One hundred and thirty-seven of the A/H1N1/2009 PCR-negative samples were additionally tested using a RealAccurate Respiratory RT-PCR panel, revealing other respiratory viruses (mainly entero/rhino- and adenoviruses) in 42.3 % (58/137). All methods analysed detected A/H1N1/2009 with excellent specificity but different sensitivities (POC test: 18.2 %; DFA staining: 38.7 %; virus isolation: 45.7 %). Therefore, the POC test was not suitable for diagnosis, detecting A/H1N1/2009 only if present in high concentrations (corresponding median C t value=19.0; range=16.5–21.4). DFA staining was also able to detect A/H1N1/2009 in specimens with a lower virus concentration (median C t value=24.0; range=16.5–29.8). Virus isolation, which was positive after a median time of 7.5 days, was too time-consuming. In summary, DFA staining is superior to POC testing and may be appropriate for patients expected to have a rather high level of virus replication. Nevertheless, in DFA-negative specimens, A/H1N1/2009 should be excluded by RT-PCR. %U https://www.microbiologyresearch.org/content/journal/jmm/10.1099/jmm.0.017244-0