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Emerging infectious diseases2021; 27(11); 2761-2767; doi: 10.3201/eid2711.211449

Effectiveness of Abbott BinaxNOW Rapid Antigen Test for Detection of SARS-CoV-2 Infections in Outbreak among Horse Racetrack Workers, California, USA.

Abstract: The Abbott BinaxNOW rapid antigen test is cheaper and faster than real-time reverse transcription PCR (rRT-PCR) for detecting severe acute respiratory syndrome coronavirus 2. We compared BinaxNOW with rRT-PCR in 769 paired specimens from 342 persons during a coronavirus disease outbreak among horse racetrack workers in California, USA. We found positive percent agreement was 43.3% (95% CI 34.6%-52.4%), negative percent agreement 100% (95% CI 99.4%-100%), positive predictive value 100% (95% CI 93.5%-100%), and negative predictive value 89.9% (95% CI 87.5%-92.0%). Among 127 rRT-PCR-positive specimens, the 55 with paired BinaxNOW-positive results had a lower mean cycle threshold than the 72 with paired BinaxNOW-negative results (17.8 vs. 28.5; p<0.001). Of 100 specimens with cycle threshold <30, a total of 51 resulted in positive virus isolation; 45 (88.2%) of those were BinaxNOW-positive. Our comparison supports immediate isolation for BinaxNOW-positive persons and confirmatory testing for negative persons.
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Publication Date: 2021-09-01 PubMed ID: 34469287PubMed Central: PMC8544964DOI: 10.3201/eid2711.211449Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study examines the effectiveness of the Abbott BinaxNOW rapid antigen test in detecting SARS-CoV-2 as compared to a traditional RT-PCR test during a Covid-19 outbreak among horse racetrack workers in California. The findings suggest that while the antigen test was successful in quickly identifying those with high viral loads, it was less effective at detecting cases with lower viral amounts.

Research Objectives

  • The primary aim of the study was to evaluate the Abbott BinaxNOW rapid antigen test’s capacity to detect SARS-CoV-2.
  • The researchers compared the BinaxNOW results with those obtained from a real-time reverse transcription PCR (rRT-PCR), often referred to as the gold standard of Covid-19 diagnostic tests.

Methodology

  • The researchers collected 769 paired specimens from 342 individuals during a Covid-19 outbreak among horse racetrack workers in California, USA. These samples were subjected to both BinaxNOW and rRT-PCR testing for comparison.

Findings

  • The Abbott BinaxNOW test showed a positive percent agreement of 43.3%, indicating its ability to accurately detect positive cases was substantially lower than rRT-PCR.
  • Negative percent agreement was found to be 100%, suggesting the rapid test was able to correctly identify all negative cases, as per the rRT-PCR results.
  • The positive predictive value was also 100%, meaning all the subjects that tested positive with BinaxNOW were indeed infected with SARS-CoV-2, showing no false positives occurred.
  • The negative predictive value was lower, at 89.9%, implying that some subjects who tested negative with BinaxNOW were actually infected.
  • Out of 127 rRT-PCR-positive specimens, BinaxNOW detected only 55 cases. These 55 cases had a lower mean cycle threshold than the undetected 72, indicating the antigen test is likely more sensitive to higher viral loads.
  • Out of 100 specimens with a cycle threshold of less than 30, 51 were able to result in virus isolation. Among these, 45 (or 88.2%) were detected as positive by the BinaxNOW test.

Conclusion

  • The results of this study suggest that the BinaxNOW test is most effective in identifying people with high viral loads and should be used to support immediate isolation of positive individuals.
  • However, due to its lower sensitivity in detecting cases with lower viral loads, negative results from the BinaxNOW test should be confirmed with a follow-up rRT-PCR test, to safeguard against potential false negatives in the context of community transmission.

Cite This Article

APA
Surasi K, Cummings KJ, Hanson C, Morris MK, Salas M, Seftel D, Ortiz L, Thilakaratne R, Stainken C, Wadford DA. (2021). Effectiveness of Abbott BinaxNOW Rapid Antigen Test for Detection of SARS-CoV-2 Infections in Outbreak among Horse Racetrack Workers, California, USA. Emerg Infect Dis, 27(11), 2761-2767. https://doi.org/10.3201/eid2711.211449

Publication

Emerging infectious diseases
ISSN: 1080-6059
NlmUniqueID: 9508155
Country: United States
Language: English
Volume: 27
Issue: 11
Pages: 2761-2767

Researcher Affiliations

Surasi, Krishna
    Cummings, Kristin J
      Hanson, Carl
        Morris, Mary Kate
          Salas, Maria
            Seftel, David
              Ortiz, Liza
                Thilakaratne, Ruwan
                  Stainken, Cameron
                    Wadford, Debra A

                      MeSH Terms

                      • Animals
                      • Antigens, Viral
                      • COVID-19
                      • California / epidemiology
                      • Disease Outbreaks
                      • Horses
                      • Humans
                      • SARS-CoV-2
                      • Sensitivity and Specificity

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