Is Flu/COVID/RSV Testing Enough? A Comparison of Multiplex Respiratory Testing
By the bioMérieux Editors | Reading time: 2 min
PUBLICATION DATE: February 11, 2026
This articles features a comparison of the performance of BIOFIRE® SPOTFIRE® Respiratory/Sore Throat (R/ST) Panel, Cepheid Xpert® Xpress SARS-CoV-2/Flu/RSV, and Cobas® SARS-CoV-2 & Influenza A/B assay for detection of respiratory viruses.1
Background
Upper respiratory tract infections often present with similar symptoms regardless of the causative pathogen(s). However, certain pathogens require targeted therapy and management, making accurate and rapid detection essential for effective patient care and infection control. Choosing the right diagnostic tools is critical to ensure clinicians are prepared to deliver optimal care. Traditional flu/SARS-CoV-2/RSV diagnostics only tell part of the story.
This study compared the performance of three multiplex point-of-care PCR platforms for the detection of flu A/B, RSV, and SARS-CoV-2:
- SPOTFIRE R/ST Panel
- Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV
- Cobas LIAT SARS-CoV-2 & Influenza A/B assay
The sample size was 250 leftover pediatric nasopharyngeal swab (NPS) specimens.
Key Takeaways
High Agreement for Flu and RSV: All platforms demonstrated 95% positive percent agreement (PPA) and negative percent agreement (NPA) for flu A, flu B, and RSV detection.
SARS-CoV-2 Performance: PPA ranged from 86% (Liat) to >95% (SPOTFIRE and Xpress).
Additional Detections: The 15-target SPOTFIRE R/ST Panel offered added value by detecting additional pathogens, supporting more comprehensive patient management. The SPOTFIRE panel identified other respiratory viruses in 44% of samples, offering broader diagnostic coverage.
Workflow Efficiency: Hands-on time was 2.5 minutes or less for all assays. Total turnaround time varied, with the SPOTFIRE panel providing results fastest.
Additional Detections on BIOFIRE® SPOTFIRE®
Respiratory virus | N, % | Single Detection (n) | Co-detection (n) |
|---|---|---|---|
Adenovirus | 55, 22% | 12 | 43 |
Human rhinovirus/enterovirus | 50, 20% | 7 | 43 |
Coronavirus (seasonal) | 26, 10.4% | 4 | 22 |
Parainfluenza | 5, 2% | 0 | 5 |
Human metapneumovirus | 3, 1.2% | 3 | 0 |
Workflow Results
| Platform | Assay Loading (Avg time, sec) | Software operation (Avg time, sec) | Result retrieval (Avg time, sec) | Total hands-on time (Avg time, sec) | Time for assay completion (Avg time, min) | Total Turn-around Time (Avg time, min) |
|---|---|---|---|---|---|---|
SPOTFIRE | 95 | 21 | 24 | 140 | 16 | 18 |
Cobas | 32 | 24 | 13 | 69 | 20 | 21 |
Xpert | 12 | 67 | 5 | 84 | 37 | 38 |
To read the full Journal of Clinical Virology article, click here.
References
- Banerjee, D, et al (2026). Head-to-head comparison of the performance of BIOFIRE® SPOTFIRE® Respiratory/Sore Throat Panel, Cepheid Xpert® Xpress SARS-CoV-2/Flu/RSV and Cobas® SARS-CoV-2 & Influenza A/B assay for detection of respiratory viruses. Journal of Clinical Virology, 182, 105902.
