AllTest FI-FLU-502 User guide

Page 1
Influenza A+B Test Cassette
REF FI-FLU-502
English
Type A
Type B
RT-PCR
RT-PCR
Positive
Negative
Positive
Negative
Influenza
Positive
110 2 112
89 2 91
Negative
2
189
191 2 187
189
Total
112
191
303
91
189
280
Sensitivity Agreement
98.2%
97.8%
Specificity Agreement
99.0%
98.9%
Overall Accuracy
98.7%
98.6%
Type A
Type B
RT-PCR
RT-PCR
Positive
Negative
Positive
Negative
Influenza
A+B
Positive
65 1 66
75 1 76
Negative
2
135
137 4 199
203
Total
67
136
203
79
200
279
Sensitivity Agreement
97.0%
94.9%
Specificity Agreement
99.3%
99.5%
Overall Accuracy
98.5%
98.2%
Type A
Type B
RT-PCR
RT-PCR
Positive
Negative
Positive
Negative
Influenza
A+B
Positive
49 2 51
89 1 90
Negative
0
245
245 2 165
167
Total
49
247
296
91
166
257
Sensitivity Agreement
100.0%
97.8%
Specificity Agreement
99.2%
99.4%
Overall Accuracy
99.3%
98.8%
Influenza A Virus
Influenza B Virus
A/NWS/33 10(H1N1) A/Hong Kong/8/68(H3N2) A/Port Chalmers/1/73(H3N2) A/WS/33(H1N1) A/New Jersey/8/76(HswN1) A/Mal/302/54(H1N1) A/chicken/Yuyao/2/2006 (H5N1) A/swine/Hubei/251/2001 (H9N2) A/Duck/Hubei/216/1983(H7N8) A/Duck/Hubei/137/1982(H10N4) A/Anhui/1/2013 (H7N9)
B/R5 B/Russia/69 B/Lee/40 B/Hong Kong/5/72
Description
Test Level
Human adenovirus C
5.62 x 105 TCID50/ml
Adenovirus type 10
3.16 x 103 TCID50/ml
Adenovirus type 18
1.58 x 104 TCID50/ml
2.65 x 104 LD50/ml
1.58 x 105 TCID50/ml
Coxsackievirus B5
1.58 x 107 TCID50/ml
Echovirus 2
3.16 x 105 TCID50/ml
Echovirus 6
3.16 x 106 TCID50/ml
Herpes simplex virus 1
1.58 x 106 TCID50/ml
Human Rhinovirus 2
2.81 x 104 TCID50/ml
Human Rhinovirus 14
1.58 x 106 TCID50/ml
Human Rhinovirus 16
8.89 x 106 TCID50/ml
Measles
1.58 x 104 TCID50/ml
Sendai virus
8.89 x 107 TCID50/ml
Parainfluenza virus 2
1.58 x 107 TCID50/ml
Parainfluenza virus 3
1.58 x 108 TCID50/ml
Respiratory syncytial virus
8.89 x 104 TCID50/ml
Rubella
2.81 x 105 TCID50/ml
Arcanobacterium
Pseudomonas aeruginosa
Candida albicans
Staphylococcus aureus subspaureus
Corynebacterium
Staphylococcus epidermidis
Enterococcus faecalis
Staphylococcus saprophylicus
Enterococcus faecium
Streptococcus agalactiae
Escherichia coli
Streptococcus bovis
Haemophilus
Streptococcus dysgalatiae/subsp.dysgalatiae
Moraxella catarrhalis
Streptococcus oralis formerly Streptococcus
Neisseria gonorrhoeae
Streptococcus pneumoniae
Neisseria lactamica
Streptococcus pyogenes
Neisseria subflava
Streptococcus salivarius
Proleus vulgaris
Streptococcus sp group F.type 2
Index of Symbols
Consult instructions
electronic instructions
for use
In vitro diagnostic
medical device
Catalogue
number
Authorized
European Community
Do not use if package
consult instructions for
use
Hangzhou AllTest Biotech Co., Ltd.
MedNet EC-REP GmbH
Borkstrasse 10 48163 Muenster Germany
(Swab/Nasal Aspirate)
Package Insert
A Fluorescence Immunoassay test kit for the diagnosis of Influenza A and Influenza B virus in nasopharyngeal swab, throat swab or nasal aspirate specimens with the use of Fluorescence Immunoassay Analyzer. For professional in vitro diagnostic use only.
INTENDED USE
The Influenza A+B Test Cassette (Swab/Nasal Aspirate) is intended for in vitro detection of influenza A and B antigens in nasopharyngeal swab, throat swab or nasal aspirate specimens. It is intended to aid in the rapid differential diagnosis of influenza A and B viral infections.
SUMMARY
Influenza (commonly known as ‘flu’) is a highly contagious, acute viral infection of the
respiratory tract. It is a communicable disease easily transmitted through the coughing and sneezing of aerosolized droplets containing live virus. each year during the fall and winter months. Type A viruses are typically more prevalent than type B viruses and are associated with most serious influenza epidemics, while type B infections are usually milder. The gold standard of laboratory diagnosis is 14-day cell culture with one of a variety of cell lines that can support the growth of influenza virus. utility, as results are obtained too late in the clinical course for effective patient intervention. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) is a newer method that is generally more sensitive than culture with improved detection rates over culture of 2-23%.
3
However, RT-PCR is expensive, complex and must be performed in specialized laboratories. The Influenza A+B Test cassette (Swab/Nasal Aspirate) qualitatively detects the presence of Influenza A and/or Influenza B antigen in nasopharyngeal swab or throat swab or nasal aspirate specimens, providing results within 15 minutes. The test uses antibodies specific for Influenza A and Influenza B to selectively detect Influenza A and Influenza B antigen in nasopharyngeal swab, throat swab or nasal aspirate specimens.
PRINCIPLE
The Influenza A+B Test Cassette (Swab/Nasal Aspirate) detects Influenza A and Influenza B nucleoproteins based on Fluorescence Immunoassay. The sample moves through the strip from sample pad to absorbent pad. If the specimen contains Influenza A and Influenza B nucleoproteins, it attaches to the fluorescent microspheres­conjugated anti- Influenza A and/or Influenza B antibodies. Then the complex will be captured by the capture antibodies coated on the nitrocellulose membrane (Test line). The concentration of Influenza A and/or Influenza B in the sample correlates with the fluorescence signal intensity captured on the T line, which can be scanned by Fluorescence Immunoassay Analyzer. The testing result of Influenza A and Influenza B will display on the Fluorescence Immunoassay Analyzer screen.
REAGENTS
The test cassette contains anti-Influenza A and B conjugated fluorophores and anti­Influenza A and B coated on the membrane.
PRECAUTIONS
1. For professional in vitro diagnostic use only.
2. Do not use after the expiration date indicated on the package. Do not use the test if
the foil pouch is damaged. Do not reuse.
3. Avoid cross-contamination of specimens by using a new specimen collection
container for each specimen obtained.
4. Do not eat, drink or smoke in the area where the specimens and tests are handled.
Handle all specimens as if they contain infectious agents. Observe established precautions against microbiological hazards throughout the procedure and follow standard procedures for proper disposal of specimens. Wear protective clothing such as laboratory coats, disposable gloves and eye protection when specimens are assayed.
5. Do not interchange or mix reagents from different lots.
6. Humidity and temperature can adversely affect results.
7. Used testing materials should be discarded in accordance with local regulations.
8. Read the entire procedure carefully prior to any testing.
9. The Influenza A+B Test Cassette should only be used with the Analyzer by
approved medical professionals.
STORAGE AND STABILITY
1. The kit should be stored at 4-30 °C until the expiry date printed on the sealed pouch.
2. The test must remain in the sealed pouch until use.
1
Influenza outbreaks occur
2
Cell culture has limited clinical
3. Do not freeze.
4. Care should be taken to protect the components of the kit from contamination. Do not use if there is evidence of microbial contamination or precipitation. Biological contamination of dispensing equipment, containers or reagents can lead to false results.
SPECIMEN COLLECTION AND PREPARATION
Preparation
Before performing the test, please make sure that all components are brought to room temperature (15-30 °C). Cold buffer solution or moisture condensation on the membrane can lead to invalid test results.
Sample Handling
• Nasopharyngeal swab sample
1. Insert a sterile swab into the nostril of the patient, reaching the surface of the posterior nasopharynx.
2. Swab over the surface of the posterior nasopharynx 5-10 times.
• Throat swab sample
Insert a sterilized swab into pharynx and collect mucoepidermis mainly wiping flare region of post-pharyngeal wall and palatine tonsil several times, and be careful not to make saliva attach to the swab.
• Nasal aspirate
Connect an aspiration catheter to an aspiration trap that is attached to an aspiration device, insert the catheter to nasal cavity from a nostril, start the aspiration device and then collect nasal aspirate sample. Dip a sterilized swab into the collected nasal aspirate sample and make the specimen cling to the swab.
MATERIALS
Materials Provided
•Test Cassettes • Extraction Reagent • Extraction Tubes
Sterile Swabs Package Insert Workstation
Extraction Tube Tips ID card
Materials Required But Not Provided
Timer • Fluorescence Immunoassay Analyzer
DIRECTIONS FOR USE
Refer to Fluorescence Immunoassay Analyzer Operation Manual for the complete instructions on use of the analyzer. The test should be conducted in room temperature.
Allow the test, specimen, buffer and/or controls to reach room temperature (15­30°C) prior to testing.
1. Turn on the Analyzer power. Then according to the need, select “standard test” or “Quick test” mode.
2. Take out the ID card and insert it into the Analyzer ID Card Slot.
3. Remove the test cassette from the sealed foil pouch and use it as soon as possible. Best results will be obtained if the assay is performed immediately after opening the foil pouch.
4. Place the Extraction Tube in the workstation. Hold the extraction reagent bottle upside down vertically. Squeeze the bottle and let the solution drop into the extraction tube freely without touching the edge of the tube. Add 10 drops of extraction reagent (Approx. 400 μL) to the Extraction Tube.
5. Place the swab specimen in the Extraction Tube. Rotate the swab for approximately 10 seconds while pressing the head against the inside of the tube to release the antigen in the swab.
6. Remove the swab while squeezing the swab head against the inside of the Extraction Tube as you remove it to expel as much liquid as possible from the swab. Discard the swab in accordance with your biohazard waste disposal protocol.
7. Fit the dropper tip on top of the extraction tube. Place the test cassette on a clean and level surface.
8. Add three drops of the solution (approx. 120 μL) to the sample well and then start the timer. (Follow the illustration as below)
9. There are two test modes for Fluorescence Immunoassay Analyzer, Standard Test mode and Quick Test mode. Please refer to the user manual of Fluorescence Immunoassay Analyzer for details.
“Quick test” mode: After 15 minutes of adding sample, Insert the test cassette into
the Analyzer, click “QUICK TEST”, fill the test information and click "NEW TEST" immediately. The Analyzer will automatically give the test result after a few seconds.
“Standard test” mode: Insert the test cassette into the Analyzer immediately after
adding specimen, click “STANDARD TEST”, fill the test information and click "NEW TEST" at the same time, The Analyzer will automatically countdown 15 minutes.
After the countdown, the Analyzer will give the result at once.
INTERPRETATION OF RESULTS
Results read by Fluorescence Immunoassay Analyzer. The result of tests for Influenza A+B is calculated by Fluorescence Immunoassay Analyzer and display the result on the screen. For additional information, please refer to the user manual of Fluorescence Immunoassay Analyzer.
NOTE: The test result of each specimen is given as Pos (+) or Neg (-) with a Value. This value is calculated by dividing the signal obtained with sample by cut-off value (S/C Ratio).
- Test results of Value ≥ 1.00 are considered positive for Influenza A and/or B.
- Test results of Value < 1.00 are considered negative for Influenza A and/or B.
QUALITY CONTROL
Each Influenza A+B Test Cassette contains internal control that satisfies routine quality control requirements. This internal control is performed each time a sample is tested. This control indicates that the test cassette was inserted and read properly by Fluorescence Immunoassay Analyzer. An invalid result from the internal control causes an error message on Fluorescence Immunoassay Analyzer indicating that the test should be repeated. An invalid result from the internal control causes an “N/A” message on Fluorescence Immunoassay Analyzer. Insufficient specimen volume or incorrect procedural techniques are the most likely reasons for control failure. Review the procedure and repeat the test with a new test. If the problem persists, discontinue using the test kit immediately and contact your local distributor.
LIMITATIONS
1. The Influenza A+B Test Cassette (Swab/Nasal Aspirate) is for professional in v itro diagnostic use only. The test should be used for the qualitative detection of Influenza A and/or B virus in nasopharyngeal swab, throat swab or nasal aspirate specimens.
2. The Influenza A+B Test Cassette (Swab/Nasal Aspirate) will only indicate the presence of Influenza A and/or B virus in the specimen from both viable and non­viable Influenza A and B strains.
3. As with all diagnostic tests, all results must be interpreted together with other clinical information available to the physician.
4. The test result of Value is not a quantitative value or the rate of influenza A/B virus concentration. This is only a qualitative test.
5. Excess blood or mucus on the swab specimen may interfere with test performance and may yield a false positive result.
6. The accuracy of the test depends on the quality of the swab sample. False negatives may result from improper sample collection or storage.
7. The use of over-the-counter and prescription nasal sprays at high concentrations can interfere with results, leading to either invalid or incorrect test results.
8. A positive result for influenza A and/or B does not preclude an underlying co­infection with another pathogen, therefore the possibility of an underlying bacterial infection should be considered.
9. The results of Influenza A+B Tests are based on measuring the levels of Influenza A+B in a specimen. It should not be used as the sole criterion for treatment
decisions. If the result is positive, other clinical findings and alternative test methods are recommended to reach proper medical treatments.
PERFORMANCE CHARACTERISTICS
Sensitivity, Specificity and Accuracy
The Influenza A+B Test Cassette (Swab/Nasal Aspirate) has been evaluated with specimens obtained from the patients. RT-PCR is used as the reference method for The Influenza A+B Test Cassette (Swab/Nasal Aspirate). Specimens were considered positive if RT-PCR indicated a positive result. Specimens were considered negative if RT-PCR indicated a negative result. Nasopharyngeal Swab Specimen
Total
Total
A+B
Throat Swab Specimen
Total
Total
Nasal Aspirate Specimen
Total
Total
Reactivity with Human Influenza Strain
The Influenza A+B Test Cassette (Swab/Nasal Aspirate) was tested with the following human influenza strains and the result is positive:
Specificity Testing with Various Viral Strains
Human adenovirus B 1.58 x 104 TCID50/ml
Human coronavirus OC43 2.45 x 106 LD50/ml
Coxsackievirus A9
Human herpesvirus 5 1.58 x 104 TCID50/ml
Echovirus 3 1 x 104 TCID50/ml
Human herpesvirus 2 2.81 x 105 TCID50/ml
Mumps 1.58 x 104 TCID50/ml
Human respiratory syncytial virus 1.58 x 105 TCID50/ml
Varicella-Zoster 1.58 x 103 TCID50/ml
TCID50 = Tissue Culture Infectious Dose is the dilution of virus that under the conditions
of the assay can be expected to infect 50% of the culture vessels inoculated.
LD
= Lethal Dose is the dilution of virus that under the conditions of the assay can be
50
expected to kill 50% of the suckling mice inoculated.
Precision
Intra-Assay
Inter-Assay
Within-run and Between-run precision has been determined by using five specimens of Influenza standard control. Three different lots of the Influenza Test Cassette (Swab/Nasal Aspirate) have been tested using negative, Influenza A weak, Influenza B Weak, Influenza A Strong and Influenza B Strong. Ten replicates of each level were tested each day for 3 consecutive days. The specimens were correctly identified >99% of the time.
The following organisms were tested at 1.0x10
Cross-reactivity
8
org/ml and all found to be negative
when tested with The Influenza A+B Test Cassette (Swab/Nasal Aspirate):
BIBLIOGRAPHY
1. Williams, KM, Jackson MA, Hamilton M. (2002) Rapid Diagnostic Testing for URIs in Children; Impact on Physician Decision Making and Cost. Infec. Med. 19(3): 109-
111.
2. Betts, R.F. 1995. Influenza virus, p.1546-1567. In G.L. Mandell, R.G. Douglas, Jr. and J.E. Bennett (ed.), Principle and practice of infectious diseases, 4th ed. Churchill Livingstone, Inc., New York, N.Y.
3. WHO recommendations on the use of rapid testing for influenza diagnosis, World Health Organisation, July 2005.
for use or consult
Contains
sufficient for
Temperature limit
<n> tests
Batch code
representative in the
is damaged and
Use-by date
Do not re-use
Manufacturer
Statement: Information about manufacturer of sterile swab is placed on the packaging. Distributed in Italy by PM2 Services Srl, Corso Mazzini 38- Largo Marchi, 36071 Arzignano (VI) - info@pm2services.it
Number: F145106000 Revision date: 2022-09-14
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