Comparison of Three Different Rotavirus Antigen Tests for Rotavirus Detection in Fecal Samples: A Retrospective Analysis

Abstract

Objective: Direct antigen tests are the most commonly used methods in most laboratories to detect rotavirus rapidly in stool samples. This study aimed to evaluate the performance of three commercially available test methods for detecting rotaviruses in fecal specimens and compare the results with those of the reverse transcription-polymerase chain reaction (RT-PCR), which is considered a gold standard test.Materials and Methods: The presence of rotavirus antigens in stool samples was investigated by an enzyme-linked immunosorbent assay (ELISA), an immunochromatographic test (ICT), and a latex agglutination test (LAT), which were commercially available. The results of these tests were compared with those of a multiplex RT-PCR as a reference test. Sensitivity, specificity, and positive and negative predictive values were calculated, and agreement with RT-PCR was evaluated by Cohen's kappa test.Results: A total of 85 patients (51.8% male and 48.2% female, aged 0-32 years) were included in this study. The sensitivities of the ICT, LAT, and ELISA tests were 78.6%, 78.6%, and 96.4%, respectively; the specificities of the tests were 69.0%, 72.4%, and 69.0%, respectively. According to kappa tests, moderate agreement was found between RT-PCR and ICT (Kappa=0.464, p<0.001); moderate agreement was found between RT-PCR and LAT (Kappa=0.493, p<0.001); substantial agreement was found between RT-PCR and ELISA (Kappa=0.694, p<0.001). The ELISA test showed the highest sensitivity and a high level of agreement with RT-PCR.Conclusion: ICT and LAT are quick and practical tests for rotavirus detection. However, in this study, it was seen that they were not superior to the ELISA test in terms of accuracy of diagnosis.