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Abbott BinaxNOW Rapid Antigen Test Performance in Detecting SARSCoV-2 Infections in a COVID-19 Outbreak among Horse Racetrack Workers
Open Forum Infectious Diseases ; 8(SUPPL 1):S286, 2021.
Article in English | EMBASE | ID: covidwho-1746628
ABSTRACT
Background. Rapid antigen tests (e.g., Abbott's BinaxNOW) are cheaper and faster than nucleic acid amplification tests (e.g., real-time reverse transcription polymerase chain reaction [RT-PCR]) for SARS-CoV-2 infection, with variable reported sensitivity. A horse racetrack in California experienced a COVID-19 outbreak among staff and used BinaxNOW to supplement RT-PCR. Utility of BinaxNOW in detecting SARS-CoV-2 infection in a workplace outbreak was assessed. Methods. Between November 25-December 22, 2020, anterior nasal swabs were collected from racetrack staff for six rounds of paired BinaxNOW and RT-PCR tests. BinaxNOW tests were interpreted according to manufacturer instructions. RT-PCR was performed at the state public health lab using the ThermoFisher TaqPath COVID-19 Combo Kit. Staff with positive results on either test were isolated and removed from subsequent testing. Viral cultures were attempted on specimens with cycle threshold (Ct) < 30. Results. Overall, 769 paired results from 342 staff were analyzed. Most were of Hispanic ethnicity (62.0%) and ages ranged from 18 to 92 years (median 52). BinaxNOW performance compared to RT-PCR (95% CI) was as follows positive percent agreement (PPA) 43.3% (34.6%-52.4%);negative percent agreement (NPA) 100% (99.4%-100%);positive predictive value (PPV) 100% (93.5%-100%);negative predictive value 89.9% (87.5%-92.0%). Among 127 RT-PCR-positive specimens, those with paired BinaxNOW-positive results (n = 55) had a lower mean Ct value than those with paired BinaxNOW-negative results (n = 72) (17.8 vs. 28.5) (p < 0.001). In dual positive pairs, median time from specimen collected to RT-PCR result reported was 4 days (range 1-6), compared to the 15-minute BinaxNOW reporting time. Of 100 Ct < 30 specimens, 51 resulted in positive virus isolation, 45 (88.2%) of which were BinaxNOW-positive. Conclusion. High NPA and PPV support immediate isolation of BinaxNOWpositive individuals, while low PPA supports confirmatory testing following BinaxNOW-negative results. BinaxNOW performed better in paired specimens with lower Ct value and positive viral cultures, which could suggest that among RT-PCRpositive specimens, those that are BinaxNOW-negative may be less likely to contain infectious virus than those that are BinaxNOW-positive.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Open Forum Infectious Diseases Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Language: English Journal: Open Forum Infectious Diseases Year: 2021 Document Type: Article