K Number
K162274
Device Name
Solana Strep Complete Assay
Manufacturer
Date Cleared
2016-10-25

(74 days)

Product Code
Regulation Number
866.2680
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
The Solana® Strep Complete Assay is a rapid in vitro diagnostic test, using isothermal amplification technology (helicase-dependent amplification, HDA), for the qualitative detection of Streptococcus pyogenes (Group A B-hemolytic Streptococcus) and Streptococcus dysgalactiae (pyogenic Group C and G ß-hemolytic Streptococus) nucleic acids isolated from throat swab specimens obtained from patients with signs and symptoms of pharyngitis, such as sore throat. The Solana® Strep Complete Assay is intended for use only with the the Solana® instrument.
Device Description
The Solana Strep Complete Assay amplifies, detects and differentiates Streptococcus pyogenes DNA and Streptococcus dysgalactiae DNA present in throat swab specimens obtained from symptomatic patients. The assay consists of two major steps: 1) specimen preparation, and 2) amplification and detection of target sequence specific to S. pyogenes (GAS) and S. dysgalactiae (C/G) using isothermal Helicase-Dependent Amplification (HDA) in the presence of target-specific fluorescence probe. Patient specimen on a throat swab is transferred to a Lysis Tube and subjected to heattreatment at 95±°C for 5 minutes. The heat-treated sample is added to a Dilution Tube, and then transferred to two Reaction Tubes, GAS Reaction Tube and Strep C/G Reaction Tube. GAS Reaction Tube contains white lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. pyogenes target sequence, while C/G Reaction Tube contains blue lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. dysgalactiae target sequence. Once rehydrated with the diluted sample, the Reaction Tubes are placed in a Solana Instrument for amplification and detection of the target sequences. In Solana, the target sequences are amplified by specific primers and detected by a specific fluorescence probe included in each Reaction Tube. Two competitive process controls (PRCs) are included in the Lysis Tube to monitor sample processing, inhibitory substances in clinical samples, reagent failure or device failure for each target. PRCs are amplified by the target-specific primers and detected by a PRC specific fluorescence probe. The target and PRC probes are labeled with a quencher on one end and a fluorophore on the other end. Upon annealing to target or PRC amplicons, the fluorescence signal increases due to physical separation of the fluorophore from the quencher. Solana measures and interprets the fluorescent signal for each Reaction Tube, using on-board method-specific algorithms. Solana then reports the test results for each Reaction Tube to the user on its display screen, and optionally prints out the results via a printer.
More Information

Not Found

No
The device description mentions "on-board method-specific algorithms" for interpreting fluorescent signals, which is standard for many diagnostic instruments and does not indicate the use of AI or ML. There is no mention of AI, ML, or related concepts like training or test sets for algorithmic development.

No

Explanation: The device is described as a rapid in vitro diagnostic test for the qualitative detection of specific nucleic acids, which is used to diagnose rather than treat a condition.

Yes

The device is explicitly described as a "rapid in vitro diagnostic test" for the qualitative detection of specific bacteria from patient specimens, which directly indicates its function in diagnosing medical conditions.

No

The device is an in vitro diagnostic test that includes reagents and is intended for use with a specific hardware instrument (Solana Instrument) for amplification and detection. It is not solely software.

Yes, this device is an IVD (In Vitro Diagnostic).

The very first sentence of the "Intended Use / Indications for Use" section explicitly states: "The Solana® Strep Complete Assay is a rapid in vitro diagnostic test..."

Furthermore, the description of the device and its intended use aligns perfectly with the definition of an IVD: it is used to examine specimens (throat swabs) from the human body to provide information for the diagnosis of a disease (pharyngitis caused by Streptococcus pyogenes and Streptococcus dysgalactiae).

N/A

Intended Use / Indications for Use

The Solana® Strep Complete Assay is a rapid in vitro diagnostic test, using isothermal amplification technology (helicase-dependent amplification, HDA), for the qualitative detection and differentiation of Streptococcus pyogenes (Group A β-hemolytic Streptococcus) and Streptococcus dysgalactiae (pyogenic Group C and G β-hemolytic Streptococcus) nucleic acids isolated from throat swab specimens obtained from patients with signs and symptoms of pharyngitis, such as sore throat. The Solana® Strep Complete Assay is intended for use only with the Solana® instrument.

Product codes

PGX

Device Description

The Solana Strep Complete Assay amplifies, detects and differentiates Streptococcus pyogenes DNA and Streptococcus dysgalactiae DNA present in throat swab specimens obtained from symptomatic patients.

The assay consists of two major steps: 1) specimen preparation, and 2) amplification and detection of target sequence specific to S. pyogenes (GAS) and S. dysgalactiae (C/G) using isothermal Helicase-Dependent Amplification (HDA) in the presence of target-specific fluorescence probe.

Patient specimen on a throat swab is transferred to a Lysis Tube and subjected to heattreatment at 95±°C for 5 minutes. The heat-treated sample is added to a Dilution Tube, and then transferred to two Reaction Tubes, GAS Reaction Tube and Strep C/G Reaction Tube. GAS Reaction Tube contains white lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. pyogenes target sequence, while C/G Reaction Tube contains blue lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. dysgalactiae target sequence. Once rehydrated with the diluted sample, the Reaction Tubes are placed in a Solana Instrument for amplification and detection of the target sequences. In Solana, the target sequences are amplified by specific primers and detected by a specific fluorescence probe included in each Reaction Tube. Two competitive process controls (PRCs) are included in the Lysis Tube to monitor sample processing, inhibitory substances in clinical samples, reagent failure or device failure for each target. PRCs are amplified by the target-specific primers and detected by a PRC specific fluorescence probe.

The target and PRC probes are labeled with a quencher on one end and a fluorophore on the other end. Upon annealing to target or PRC amplicons, the fluorescence signal increases due to physical separation of the fluorophore from the quencher. Solana measures and interprets the fluorescent signal for each Reaction Tube, using on-board method-specific algorithms. Solana then reports the test results for each Reaction Tube to the user on its display screen, and optionally prints out the results via a printer.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

throat swab specimens

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Precision/Reproducibility Study:
A blinded and randomized study panel containing both Streptococcus pyoqenes and Streptococcus dysgalactiae negative and positive samples (3x, 1x, 0.3x LOD) were tested at three (3) test sites (one in-house laboratory and two (2) clinical sites) with three (3) instruments. Each site tested a reproducibility panel and Assay Controls for five (5) days in triplicate. Testing was done by two operators at each site. Each operator ran the panel once a day using one lot of Solana Strep Complete Assay. A total of five hundred forty (540) specimens were tested (including controls). The Solana Strep Complete Assay generated reproducible results in this study.
Results for Streptococcus pyogenes (GAS):

  • GAS High Negative (3x LOD): 40% positive (36/90), 95% CI: 27% to 47%
  • GAS Low Positive (1x LOD): 100% positive (90/90), 95% CI: 96% to 100%
  • GAS Moderate Positive (0.3x LOD): 100% positive (90/90), 95% CI: 96% to 100%
  • GAS Negative: 0% positive (0/90), 95% CI: 0% to 4%
  • GAS Positive Control: 100% positive (90/90), 95% CI: 96% to 100%
  • GAS Negative Control: 0% positive (0/90), 95% CI: 0% to 4%

Results for Streptococcus dysgalactiae (Pyo GCS/GGS):

  • C/G High Negative (3x LOD): 23% positive (21/90), 95% CI: 16% to 33%
  • C/G Low Positive (1x LOD): 100% positive (90/90), 95% CI: 96% to 100%
  • C/G Moderate Positive (0.3x LOD): 100% positive (90/90), 95% CI: 96% to 100%
  • C/G Negative: 0% positive (0/90), 95% CI: 0% to 4%
  • C/G Positive Control: 100% positive (90/90), 95% CI: 96% to 100%
  • C/G Negative Control: 0% positive (0/90), 95% CI: 0% to 4%

Clinical Sensitivity and Specificity Study:
A prospective study was conducted from February to July 2016. Two thousand six hundred eighty-eight (2688) fresh throat swab specimens were included in this study at four (4) external and one (1) internal laboratories. A single specimen was collected per patient. Samples were collected on Polyester or Rayon Swab with liquid Amie's, Polyester Swab or Rayon swab with liquid Stuart's or nylon swab with liquid Amies.
A composite result of directly cultured patients' throat swabs combined with the culture and FDA-cleared NAAT was used as the reference. Two (2) specimens were repeatedly invalid and excluded from analysis, resulting in 2686 specimens analyzed.

Combined Clinical Sites' Results for Streptococcus pyogenes (GAS):

  • Sample size: 2686
  • Sensitivity: 98.8% (475/481), 95% CI: 97.3% to 99.4%
  • Specificity: 98.9% (2180/2205), 95% CI: 98.3% to 99.2%

Combined Clinical Sites' Results for Streptococcus dysgalactiae (Pyo GCS/GGS):

  • Sample size: 2686
  • Sensitivity: 100% (78/78), 95% CI: 95.3% to 100%
  • Specificity: 99.5% (2594/2608), 95% CI: 99.1% to 99.7%

Analytical Reactivity (Inclusivity) Study:
The inclusivity of the Solana® Strep Complete Assay was evaluated by functional testing of organisms in addition to those strains used in the LOD study. Seven (7) strains of Streptococcus pyogenes (GAS) and twenty five (25) Streptococcus dysgalactiae (C/G) strains were tested at concentrations at a LOD of 8.5x10^4 CFU/mL and 7.1x10^5 CFU/mL, respectively. All tested strains were detected by the assay.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

For Streptococcus pyogenes (GAS):

  • Sensitivity: 98.8%
  • Specificity: 98.9%

For Streptococcus dysgalactiae (Pyo GCS/GGS):

  • Sensitivity: 100%
  • Specificity: 99.5%

Predicate Device(s)

Lyra® Direct Strep, K133883

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 866.2680

Streptococcus spp. nucleic acid-based assay.(a)
Identification. AStreptococcus spp. nucleic acid-based assay is a qualitative in vitro diagnostic device intended to simultaneously detect and identify variousStreptococcus spp. nucleic acids extracted directly from clinical specimens. The device detects specific nucleic acid sequences for organism identification. The identification aids in the diagnosis of diseases caused by bacteria belonging to the genusStreptococcus and provides epidemiological information on these diseases. Pathogenic streptococci are associated with infections, such as sore throat, impetigo (an infection characterized by small pustules on the skin), urinary tract infections, rheumatic fever, and kidney disease.(b)
Classification. Class II (special controls). The special controls for this device are:(1) Premarket notification submissions must include detailed device description documentation, including the device components, ancillary reagents required but not provided, and a detailed explanation of the methodology including primer/probe sequence, design, and rationale for sequence selection.
(2) Premarket notification submissions must include detailed documentation from the following analytical and clinical performance studies: Analytical sensitivity (Limit of Detection), reactivity, inclusivity, precision, reproducibility, interference, cross reactivity, carry-over, and cross contamination.
(3) Premarket notification submissions must include detailed documentation from a clinical study. The study, performed on a study population consistent with the intended use population, must compare the device performance to results obtained from well-accepted reference methods.
(4) Premarket notification submissions must include detailed documentation for device software, including, but not limited to, software applications and hardware-based devices that incorporate software.
(5) Premarket notification submissions must include database implementation methodology, construction parameters, and quality assurance protocols, as appropriate.
(6) The device labeling must include limitations regarding the need for culture confirmation of negative specimens, as appropriate.
(7) A detailed explanation of the interpretation of results and acceptance criteria must be included in the device's 21 CFR 809.10(b)(9) compliant labeling.
(8) Premarket notification submissions must include details on an end user device training program that will be offered while marketing the device, as appropriate.

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Image /page/0/Picture/1 description: The image shows the logo for the Department of Health & Human Services - USA. The logo is a circular seal with the words "DEPARTMENT OF HEALTH & HUMAN SERVICES - USA" around the perimeter. Inside the circle is an abstract image of an eagle with three heads. The eagle is facing to the right.

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-0002

October 25, 2016

QUIDEL CORPORATION RONALD LOLLAR SENIOR DIRECTOR, CLINICAL REGULATORY, SCIENTIFIC AFFAIRS 2005 EAST STATE STREET, SUITE 100 ATHENS OH 45701

Re: K162274

Trade/Device Name: Solana Strep Complete Assay Regulation Number: 21 CFR 866.2680 Regulation Name: Streptococcus spp. nucleic acid-based assay Regulatory Class: II Product Code: PGX Dated: August 10, 2016 Received: August 12, 2016

Dear Mr. Lollar:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food. Drug. and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21. Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); medical device reporting (reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

1

If you desire specific advice for your device on our labeling regulations (21 CFR Parts 801 and 809), please contact the Division of Industry and Consumer Education at its toll-free number (800) 638 2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Industry and Consumer Education at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address

http://www.fda.gov/MedicalDevices/ResourcesforYou/Industry/default.htm.

Sincerely yours,

Ribhi Shawar -S

For Uwe Scherf, M.Sc., Ph.D. Director Division of Microbiology Devices Office of In Vitro Diagnostics and Radiological Health Center for Devices and Radiological Health

Enclosure

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Indications for Use

510(k) Number (if known) K162274

Device Name Solana® Strep Complete Assay

Indications for Use (Describe)

The Solana® Strep Complete Assay is a rapid in vitro diagnostic test, using isothermal amplification technology (helicase-dependent amplification, HDA), for the qualitative detection of Streptococcus pyogenes (Group A B-hemolytic Streptococcus) and Streptococcus dysgalactiae (pyogenic Group C and G ß-hemolytic Streptococus) nucleic acids isolated from throat swab specimens obtained from patients with signs and symptoms of pharyngitis, such as sore throat. The Solana® Strep Complete Assay is intended for use only with the the Solana® instrument.

Type of Use (Select one or both, as applicable)
☑ Prescription Use (Part 21 CFR 801 Subpart D)
☐ Over-The-Counter Use (21 CFR 801 Subpart C)

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Applicant:

Quidel Corporation 12544 High Bluff Drive, Suite 200 San Diego, California 92130 Telephone: 858-552-7910 Fax: 858-646-8045

Contact Information:

Ronald H. Lollar, Senior Director Clinical and Regulatory Affairs 2005 East State Street, Suite 100 Athens, Ohio 45701 740-589-3300 – Corporate number 740-589-3373 – Desk phone 858-552-6451—Fax Ron.Lollar@quidel.com

Date of preparation of 510(k) summary:

August 10, 2016

A. 510(k) Number:

K162274

B. Purpose for Submission:

To obtain substantial equivalence for the Solana® Strep Complete Assay when performed on the Solana® instrument

C. Measurand:

DNase B (sdaB) sequence of Streptococcus pyogenes (Group A Streptococcus) Protein G gene of Streptococcus dysgalactiae (pyogenic Group C and G β-hemolytic Streptococcus)

D. Type of Test:

Helicase-dependent amplification (HDA)

4

E. Applicant:

Quidel Corporation

F. Proprietary and Established Names:

Solana® Strep Complete Assay

G. Regulatory Information:

Product CodeClassificationRegulation SectionPanel
PGX – Groups A, C and G Beta-
Hemolytic
Streptococcus
Nucleic Acid
AmplificationClass II (Non-exempt)21 CFR 866.2680 – Streptococcus spp. Nucleic Acid-Based AssayMicrobiology (83)

H. Intended Use:

1. Intended Use(s):

The Solana® Strep Complete Assay is a rapid in vitro diagnostic test, using isothermal amplification technology (helicase-dependent amplification, HDA), for the qualitative detection and differentiation of Streptococcus pyogenes (Group A β-hemolytic Streptococcus) and Streptococcus dysgalactiae (pyogenic Group C and G β-hemolytic Streptococcus) nucleic acids isolated from throat swab specimens obtained from patients with signs and symptoms of pharyngitis, such as sore throat. The Solana® Strep Complete Assay is intended for use only with the Solana® instrument.

    1. Indication(s) for Use:
      Same as intended Use
    1. Special conditions for use statement(s):
    • For in vitro diagnostic use only
    • . For prescription use only

5

4. Special instrument requirements:

Solana® instrument

Device Description: l.

The Solana Strep Complete Assay amplifies, detects and differentiates Streptococcus pyogenes DNA and Streptococcus dysgalactiae DNA present in throat swab specimens obtained from symptomatic patients.

The assay consists of two major steps: 1) specimen preparation, and 2) amplification and detection of target sequence specific to S. pyogenes (GAS) and S. dysgalactiae (C/G) using isothermal Helicase-Dependent Amplification (HDA) in the presence of target-specific fluorescence probe.

Patient specimen on a throat swab is transferred to a Lysis Tube and subjected to heattreatment at 95±°C for 5 minutes. The heat-treated sample is added to a Dilution Tube, and then transferred to two Reaction Tubes, GAS Reaction Tube and Strep C/G Reaction Tube. GAS Reaction Tube contains white lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. pyogenes target sequence, while C/G Reaction Tube contains blue lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. dysgalactiae target sequence. Once rehydrated with the diluted sample, the Reaction Tubes are placed in a Solana Instrument for amplification and detection of the target sequences. In Solana, the target sequences are amplified by specific primers and detected by a specific fluorescence probe included in each Reaction Tube. Two competitive process controls (PRCs) are included in the Lysis Tube to monitor sample processing, inhibitory substances in clinical samples, reagent failure or device failure for each target. PRCs are amplified by the target-specific primers and detected by a PRC specific fluorescence probe.

The target and PRC probes are labeled with a quencher on one end and a fluorophore on the other end. Upon annealing to target or PRC amplicons, the fluorescence signal increases due to physical separation of the fluorophore from the quencher. Solana measures and interprets the fluorescent signal for each Reaction Tube, using on-board method-specific algorithms. Solana then reports the test results for each Reaction Tube to the user on its display screen, and optionally prints out the results via a printer.

6

Quidel Corporation

510(k) Summary

Materials Provided:

● 48 Tests per Kit

ComponentQuantityStorage
Strep Complete Lysis Buffer48 tubes/kit 0.5 mL2°C to 8°C
Strep Dilution Buffer48 tubes/kit 0.5 mL2°C to 8°C
GAS Reaction Tubes48 tubes/kit2°C to 8°C
Strep C/G Reaction Tubes48 tubes/kit2°C to 8°C

Materials required but not provided:

  • . External controls for Group A Streptococcus (e.g. Quidel Molecular A + G Streptococci Control Set #M111, which contains positive and negative controls, serves as an external processing and extraction control)
  • Sterile DNase-free filter-blocked or positive displacement micropipettor tips
  • Micropipettor ●
  • Stopwatch or timer
  • Scissors or a blade
  • Heat block capable of 95° C ± 2° C temperature
  • . Solana workflow tray and transfer rack
  • Solana Instrument
  • Thermometer ●

Substantial Equivalence Information: J.

    1. Predicate device name(s):
      Lyra® Direct Strep
    1. Predicate 510(k) number(s): K133883
    1. Comparison with predicate:
Similarities
ItemSolana® Strep Complete AssayLyra™ Direct Strep Assay
(K133883)
Intended UseThe Solana® Strep Complete Assay is a rapid in vitro diagnostic test, usingThe Lyra Direct Strep Assay is a Real-Time PCR in vitro diagnostic test for
Similarities
ItemSolana® Strep Complete
AssayLyra™ Direct Strep Assay
(K133883)
isothermal amplification
technology (helicase-
dependent amplification,
HDA), for the qualitative
detection and
differentiation of
Streptococcus pyogenes
(Group A β-hemolytic
Streptococcus) and
Streptococcus dysgalactiae
(pyogenic Group C and G β-
hemolytic Streptococcus)
nucleic acids isolated from
throat swab specimens
obtained from patients with
signs and symptoms of
pharyngitis, such as sore
throat. The Solana® Strep
Complete Assay is intended
for use only with the
Solana® instrument.the qualitative detection
and differentiation of
Group A β-hemolytic
Streptococcus
( Streptococcus pyogenes )
and pyogenic Group C
and G β-hemolytic
Streptococcus nucleic
acids isolated from
throat swab specimens
obtained from patients
with signs and symptoms
of pharyngitis, such as
sore throat. The assay
does not differentiate
between pyogenic
Groups C and G β-
hemolytic Streptococcus.
All negative test results
should be confirmed by
bacterial culture,
because negative results
do not preclude Group A,
C or G Strep infection
and should not be used
as the sole basis for
treatment.
The assay is intended for
use in hospital, reference,
or state laboratory
settings. The device is not
intended for point-of-care use.
Similarities
ItemSolana® Strep Complete
AssayLyra™ Direct Strep Assay
(K133883)
Sample TypesThroat swab specimensSame
Sample Heat LysisManualSame
Detection TechniqueAutomatically detects
fluorescence after
dissociation of fluorophore
from quencher during
amplificationSame

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8

Differences
ItemSolana® Strep Complete AssayLyra™ Direct Strep Assay (K133883)
DNA Amplification TechnologyHelicase-dependent amplification (HDA); self-containedReal time polymerase chain reaction
InstrumentSolana™ABI 7500 Fast DX Thermocycler
Target Sequence Detected78 base pair (bp) sequence
S. pyogenes genome, resident in the DNase B ( sdaB ) gene

67 base pair (bp) sequence
Protein G gene of S. dysgalactiae (pyogenic Group C and G β-hemolytic Streptococcus) | GAS – 99bp product in the putative competence ( comX1.1 ) gene

Pyo GCS/GGS – 188bp product in the tagatose-6-phosphate kinase ( lacC ) gene |

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ItemSolana® Strep Complete AssayLyra™ Direct Strep Assay (K133883)
Testing Time25 minutes60 -70 minutes
Clinical SensitivityGAS* Sensitivity:
98.8%[95% CI: 97.3% to
99.4%]
Pyo GCS/GGS* S.
dysgalactiae Sensitivity:
100%[95% CI: 95.3% -
100%]GAS* Sensitivity:
96.5%[95% CI: 91.3% -
98.6%]
Pyo GCS/GGS* Sensitivity:
95.7%[95% CI: 88.1% -
98.5%]
Clinical SpecificityGAS* Specificity:
98.9%[95% CI: 98.3% to
99.2%]
Pyo GCS/GGS* S.
dysgalactiae Specificity:
99.5%[95% CI: 99.1% -
99.7%]GAS* Specificity:
98.0%[95% CI: 97.0% -
98.6%]
Pyo GCS/GGS* Specificity:
98.3%[95% CI: 97.4% -
98.9%]

*GAS = Group A Streptococcus; Pyo GCS/GGS = Pyogenic Group C/G Streptococcus

K. Standard/Guidance Document Referenced (if applicable):

Not applicable

L. Test Principle:

Patient specimen on a throat swab is transferred to a Lysis Tube and subjected to heattreatment at 95°±2°C for 5 minutes. The heat-treated sample is added to a Dilution Tube, and then transferred to two Reaction Tubes, GAS Reaction Tube and Strep C/G Reaction Tube. GAS Reaction Tube contains white lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. pyogenes target sequence, while C/G Reaction Tube contains blue lyophilized HDA reagents, dNTPs, primers and probes specific for the amplification and detection of S. dysgalactiae target sequence. Once rehydrated with the diluted sample, the Reaction Tubes are placed in a Solana Instrument for amplification and detection of the target sequences. In Solana, the target sequences are

10

amplified by specific primers and detected by a specific fluorescence probe included in each Reaction Tube. Two competitive process controls (PRCs) are included in the Lysis Tube to monitor sample processing, inhibitory substances in clinical samples, reagent failure or device failure for each target. PRCs are amplified by the target-specific primers and detected by a PRC specific fluorescence probe.

The target and PRC probes are labeled with a quencher on one end and a fluorophore on the other end. Upon annealing to target or PRC amplicons, the fluorescence signal increases due to physical separation of the fluorophore from the quencher. Solana measures and interprets the fluorescent signal for each Reaction Tube, using on-board method-specific algorithms. Solana then report the test results for each Reaction Tube to the user on its display screen, and optionally prints out the results via a printer.

M. Performance Characteristics:

1. Analytical performance:

  • a. Precision/Reproducibility:

Reproducibility

In order to confirm the reproducibility of the Solana Strep Complete Assay a blinded and randomized study panel containing both Streptococcus pyoqenes and Streptococcus dysgalactiae negative and positive samples (3x, 1x, 0.3x LOD) were tested at three (3) test sites (one in-house laboratory and two (2) clinical sites) with three (3) instruments. Each site tested a reproducibility panel and Assay Controls for five (5) days in triplicate. Testing was done by two operators at each site. Each operator ran the panel once a day using one lot of Solana Strep Complete Assay. A total of five hundred forty (540) specimens were tested (including controls). The Solana Strep Complete Assay generated reproducible results in this study.

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| Streptococcus
pyogenes
Category | SITE | | | | | | Overall Percent
Positive | 95%
Confidence
Interval | |
|---------------------------------------|-------------------------------------|---------------|-------------------------------------|---------------|-------------------------------------|---------------|-----------------------------|-------------------------------|-------------|
| | Site #1 | | Site #2 | | Site #3 | | | | |
| | Detected:
#positive /#
tested | %
Positive | Detected:
#positive /#
tested | %
Positive | Detected:
#positive /#
tested | %
Positive | | | |
| GAS High Negative | 13/30 | 43% | 10/30 | 33% | 13/30 | 43% | 36/90 | 40% | 27% to 47% |
| GAS Low Positive | 30/30 | 100% | 30/30 | 100% | 30/30 | 100% | 90/90 | 100% | 96% to 100% |
| GAS Moderate Positive | 30/30 | 100% | 30/30 | 100% | 30/30 | 100% | 90/90 | 100% | 96% to 100% |
| GAS Negative | 0/30 | 0% | 0/30 | 0% | 0/30 | 0% | 0/90 | 0% | 0% to 4% |
| GAS Positive Control | 30/30 | 100% | 30/30 | 100% | 30/30 | 100% | 90/90 | 100% | 96% to 100% |
| GAS Negative Control | 0/30 | 100% | 0/30 | 0% | 0/30 | 0% | 0/90 | 0% | 0% to 4% |

| Streptococcus
dysgalactiae
Category | SITE | | Site #1 | | Site #2 | | Site #3 | | Overall Percent
Positive | 95%
Confidence
Interval |
|-------------------------------------------|-------|-------------------------------------|---------------|-------------------------------------|---------------|-------------------------------------|---------------|------|-----------------------------|-------------------------------|
| | | Detected:
#positive /#
tested | %
Positive | Detected:
#positive /#
tested | %
Positive | Detected:
#positive /#
tested | %
Positive | | | |
| C/G High Negative | 10/30 | 33% | 6/30 | 20% | 5/30 | 17% | 21/90 | 23% | 16% to 33% | |
| C/G Low Positive | 30/30 | 100% | 30/30 | 100% | 30/30 | 100% | 90/90 | 100% | 96% to 100% | |
| C/G Moderate Positive | 30/30 | 100% | 30/30 | 100% | 30/30 | 100% | 90/90 | 100% | 96% to 100% | |
| C/G Negative | 0/30 | 0% | 0/30 | 0% | 0/30 | 0% | 0/90 | 0% | 0% to 4% | |
| C/G Positive Control | 30/30 | 100% | 30/30 | 100% | 30/30 | 100% | 90/90 | 100% | 96% to 100% | |
| C/G Negative Control | 0/30 | 0% | 0/30 | 0% | 0/30 | 0% | 0/90 | 0% | 0% to 4% | |

The results suggest that there are no significant differences between different users using different instruments at different sites on different days.

  • b. Linearity/assay reportable range:
    Not applicable – This assay is qualitative.

  • c. Traceability, Stability, Expected values (controls, calibrators, or methods):
    Traceability:

Not applicable. This assay is qualitative.

12

Specimen Stability:

A study was performed to determine the stability of samples collected in a number of routinely used swab systems: nylon flocked swabs in Amies media, Rayon swab in Amies media, polyester swab in Amies media, Rayon swab in Stuart media, polyester swab in Stuart media, and Rayon in Amies gel.

Freshly grown stocks of Streptococcus pyogenes and Streptococcus dysqalactiae, of known titer, were used to spike the swabs listed above. The spiked samples were stored at 25°C ± 2°C for 2 days and then at 2° to 8°C for up to 6 more days prior to being tested in the Solana® Strep Complete Assay. A separate study was performed where the spiked samples were stored at ≤-15℃ or ≤-70℃ for a minimum of 32 days before testing.

Based on this study, specimens collected using various collection/transport systems listed above can be stored at 25°C ± 2°C for 2 days and then at 2 to 8°C for up to 6 more days before testing or at ≤-15℃ or ≤-70℃ for up to 32 days before testing.

Controls:

External Controls (Quidel Molecular A + G Streptococci Control Set #M111, which contains positive and negative controls, serves as an external processing and extraction control) were run on the Solana® Strep Complete Assay each day of testing.

The assay controls are described as follows:

  • a. The process control is used to monitor sample processing, to detect HDA inhibitory specimens and to confirm the integrity of assay reagents and Solana instrument functionality. The process control is included in the Lysis Buffer tube.
  • b. The external positive control may be treated as a patient specimen. The control should be sampled and tested as if it were a specimen and processed as described in the Assay Procedure. The external positive control is intended to monitor substantial reagent and instrument failure.

13

  • c. The external neqative control may be treated as a patient specimen. The control should be sampled and tested as if it were a specimen and processed as described in the Assay Procedure. The external negative control is used to detect reagent or environmental contamination (or carry-over) by Streptococcus pyogenes or Streptococcus dysgalactiae DNA or amplicon.
  • d. Detection limit:

The analytical sensitivity (limit of detection or LOD) of the Solana® Strep Complete Assay was determined using quantified (CFU/mL) cultures of two (2) Streptococcus pyogenes and two (2) Streptococcus dysqalactiae strains by serially dilution. Analytical sensitivity (LOD) is defined as the lowest concentration at which 95% of all replicates tested positive.

The LOD for the two (2) Streptococcus pyogenes strains tested were 1.5x10" CFU/mL (ATCC #19615) and 8.5x10 CFU/mL (ATCC #12344). The LOD for the two (2) Streptococcus dysgalactiae strains were 5.7x10 CFU/mL (ATCC #12394) and 7.1x10 ر CFU/mL (ATCC #10009).

Based on this data the reported LOD for Streptococcus pyogenes and Streptococcus dysgalactiae using the Solana® Strep Complete Assay is 8.5x10* CFU/mL and 7.1x105 CFU/mL, respectively.

  • e. Analytical specificity:

Cross Reactivity:

An in silico BLAST analysis of primers used in the Solana® Strep Complete Assay against sixty-one (61) potential interfering organisms (see below) did not show evidence of cross-reactivity.

Arcanobacterium sp.Human adenovirus FLactobacillus sp.1
Bacillus sp.Human adenovirus GLegionella pneumophila
Bacteroides sp.2Human coronavirus 229EMeasles virus
Bordetella sp.Human coronavirus HKU1Human Metapneumovirus

Includes L. acidophilus

2 Includes B. ovatus

14

Branhamella sp.Human coronavirus NL63Moraxella sp.
Burkholderia sp.Human enterovirus AMumps virus
Campylobacter sp.3Human enterovirus BMycoplasma pneumoniae
Candida sp.Human enterovirus CNeisseria sp.
Corynebacterium sp.Human enterovirus DPeptostreptococcus sp.
CytomegalovirusHuman herpesvirus 1Proteus sp.
Enterobacterio phage MS2Human herpesvirus 2Pseudomonas sp.
Enterococcus sp.Human herpesvirus 4Respiratory syncytial virus Type B
Escherichia coliHuman parainfluenza virus 1Saccharomyces cerevisiae
Fusobacterium sp.Human parainfluenza virus 2Serratia sp.
Haemophilus sp.Human parainfluenza virus 3Staphylococcus sp.
Human adenovirus AHuman parainfluenza virus 4a and 4bTreponema sp.
Human adenovirus BInfluenza virus AVeillonella sp.
Human adenovirus CInfluenza virus BYersinia sp.
Human adenovirus DInfluenza virus CPrevotella oralis4
Human adenovirus EKlebsiella sp.Parvimonas micra5
Veillonella parvula

A study was performed to evaluate the performance of the Solana® Strep Complete Assay in the presence of forty-five (45) microorganisms commonly found in throat specimens. Each potentially interfering microorganism was tested in the presence of 2 x LOD Streptococcus pyogenes and Streptococcus dysgalactiae (2 strains each) in the presence of clinically relevant levels of viruses (10 pfu/ml) and bacteria (10 °cfu/mL) or higher. All strain combinations were spiked on to swabs. The strains included in the cross-reactivity study are shown in the table below.

Acinetobacter IwoffiiStaphylococcus epidermidis MRSE
Arcanobacterium haemolyticumStenotrophomonas maltophilia
Bacillus cereusStreptococcus agalactiae
Bordetella pertussisStreptococcus anginosus

3 Includes C. rectus

4 In NCBI, Bacteroides oralis is Prevotella oralis.

్ In NCBI, Peptostreptococcus micros is Parvimonas micra.

15

Burkholderia cepaciaStreptococcus bovis
Corynebacterium diphtheriaStreptococcus canis
Enterococcus faecalisStreptococcus gordonii (Virdans type)
Escherichia coliStreptococcus intermedius
Fusobacterium necrophorumStreptococcus mitis
Haemophilus influenza type AStreptococcus mutans
Klebsiella pneumoniaStreptococcus oralis
Lactobacillus acidophilusStreptococcus pneumoniae
Lactococcus lactisStreptococcus salivarius
Legionella jordanisStreptococcus sanguinis
Legionella micdadeiStreptococcus suis
Legionella pneumophilaCandida albicans
Moraxella cartarrhalisAdenovirus Type 1
Neisseria gonorrhoeaeAdenovirus Type 11 (Slobitski)
Neisseria subflavaInfluenza A
Peptostreptococcus micros (aka Parvimonas
micra)Influenza B
Pseudomonas aeruginosaParainfluenza Type 4B (VR-1377)
Serratia marcescensRhinovirus Type 15 (1734)
Staphylococcus aureus MRSA

Of the 45 microorganisms tested that might be found in throat specimens, Klebsiella pneumoniae, Serratia marcescens and Enterococcus faecalis each cross-reacted once out of six times tested (triplicate testing was repeated for each cross-reactive strain) with the Solana® Strep Complete Assay.

Interference:

A study was conducted using two strains of Streptococcus pyogenes (ATCC 19615 and 12344) and Streptococcus dysgalactiae strains (ATCC 12394 and ATCC 10009) tested near LOD to evaluate the Solana® Strep Complete Assay for potential interference using a panel consisting of twenty-eight (28) common biological and chemical substances found in throat samples. Substances were introduced into the swabs at concentrations which were medically relevant. Each of the strains was tested for each substance. None of the substances tested were found to interfere with the Solana® Strep Complete Assay.

16

Substance NameTest ConcentrationInterference? (Y/N)
Children's Dimetapp DM Cold & Cough
Elixir25% v/vNo
Chloraseptic Max: Sore Throat Relief10% v/vNo
BreathSavers 3 Hour Mint-Spearmint10% w/vNo
Cepacol Sore Throat: Cherry Flavor5% w/vNo
Robitussin Cough & Cold-CF Max10% v/vNo
Ricola Mountain Herb Throat Drops-
Sugar Free15% w/vNo
Human Saliva10% v/vNo
Robitussin Nighttime Cold, & Flu10% v/vNo
Crest Pro-Health Night Mint25% v/vNo
CVS Tussin CF15% v/vNo
Chloraseptic Throat Cherry lozenge10% w/vNo
Halls Cherry Mentholyptus15% w/vNo
Tic Tac Freshmints10% w/vNo
Zicam® Oral Mist0.625% v/vNo
Sucrets Complete-Vapor Cherry5% w/vNo
Acetaminophen19.5 mg/mLNo
Aspirin12.3 mg/mLNo
Ibuprofen15.6 mg/mLNo
Benadryl2.7 mg/mLNo
Crest® Complete Toothpaste5% w/vNo
Contac® Cold + Flu Caplets Night10% w/vNo
Children's Wal-Tap Elixir Cold & Allergy
(Dimetap Children's Cold and Allergy)25% v/vNo
Children's Wal-Tap DM Elixir Cold &
Cough25% v/vNo
Robitussin Nighttime Cough, Cold, & Flu
(peak cold)10% v/vNo
Halls Mentholyptus (not cherry flavor)15% w/vNo
Listerine Cool Mint Antiseptic15% v/vNo
Whole Blood5% v/vNo
Mucin (Bovine Submaxillary Gland, type I-
s)5.0 mg/mLNo

17

Analytical Reactivity (Inclusivity):

The inclusivity of the Solana® Strep Complete Assay was further evaluated by functional testing of organisms in addition to those strains used in the LOD study. Seven (7) strains of Streptococcus pyogenes (GAS) and twenty five (25) Streptococcus dysgalactiae (C/G) strains were tested at concentrations at a LOD of 8.5x104 CFU/mL and 7.1x10 CFU/mL, respectively.

Bacterial speciesBacterial StrainConcentration CFU/mLStrain Detected (Yes/No)
Streptococcus pyogenesATCC 123848.5x104Yes
Streptococcus pyogenesNCIMB 132858.5x104Yes
Streptococcus pyogenesCCUG 330618.5x104Yes
Streptococcus pyogenesCCUG 334098.5x104Yes
Streptococcus pyogenesCCUG 391588.5x104Yes
Streptococcus pyogenesATCC 493998.5x104Yes
Streptococcus pyogenesCCUG 535538.5x104Yes
S. dysgalactiae subspecies equisimilis group GATCC 66447.1x105Yes
S. dysgalactiae subspecies equisimilis group CATCC 95427.1x105Yes
S. dysgalactiae subspecies equisimilis group CATCC 123887.1x105Yes
S. dysgalactiae subspecies equisimilis group CATCC 356667.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 5027.1x105Yes
S. dysgalactiae subspecies equisimilis group CCCUG 14837.1x105Yes
S. dysgalactiae subspecies equisimilis group CCCUG 67137.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 156797.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 156807.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 215577.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 240707.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 261477.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 274777.1x105Yes
S. dysgalactiae subspecies equisimilis group CCCUG 274797.1x105Yes
S. dysgalactiae subspecies equisimilis group CCCUG 274807.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 274827.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 274837.1x105Yes
S. dysgalactiae subspecies dysgalactiae group CCCUG 276587.1x105Yes
S. dysgalactiae subspecies dysgalactiae group CCCUG 276597.1x105Yes
S. dysgalactiae subspecies dysgalactiae group CCCUG 276647.1x105Yes
S. dysgalactiae subspecies dysgalactiae group CCCUG 281157.1x105Yes
S. dysgalactiae subspecies dysgalactiae group CCCUG 281167.1x105Yes
S. dysgalactiae subspecies equisimilis group CCCUG 282387.1x105Yes
S. dysgalactiae subspecies equisimilis group GCCUG 338027.1x105Yes
S. dysgalactiae subspecies dysgalactiae group CCCUG 484777.1x105Yes
  • f. Assay cut-off:
    Not applicable.

18

    1. Comparison studies:
    • a. Method comparison with predicate device:

Not applicable

  • b. Matrix comparison:
    A comparison study was conducted between negative clinical matrix and the contrived negative matrices used in the analytical studies in order to validate their use. The matrix comparison study results are shown in the table below.

| | | Contrived Negative
Matrix | | Pooled Negative
Clinical Matrix | |
|-----------------------------------------------------|---------|------------------------------|-------|------------------------------------|-------|
| | | Detected | % Pos | Detected | % Pos |
| Streptococcus
pyogenes
ATCC 19615 | 1 x LOD | 20/20 | 100% | 20/20 | 100% |
| Streptococcus
dysgalactiae
ATCC 12394 | 1 x LOD | 20/20 | 100% | 20/20 | 100% |

These studies demonstrate that the contrived negative matrices do not alter the performance of the device in the context of these analytical studies.

3. Clinical studies:

a. Clinical Sensitivity:

Performance characteristics of the Solana Strep Complete Assay were established during a prospective study during the winter through summer of 2016 (February to July). Two thousand six hundred eighty-eight (2688) fresh throat swab specimens were included in this study at four (4) external and one (1) internal laboratories across the United States using the same swab that was plated for the culture. A single specimen was collected per patient. Samples were collected on Polyester or Rayon Swab with liquid Amie's, Polyester Swab or Rayon swab with liquid Stuart's or nylon swab with liquid Amies.

19

A composite result of directly cultured patients' throat swabs combined with the culture. Cultured isolates were typed by latex agglutination. β-hemolytic isolates that were typed as Group C or G were subcultured and the species were determined using an FDA-cleared MALDI TOF assay. Swab transport fluid was also tested using another FDA cleared nucleic acid amplification test (NAAT) and cultured at a central reference laboratory. Results from culture and NAAT were used to calculate assay sensitivity and specificity. Each site cultured the swabs prior to performing the Solana Strep Complete Assay. The swab specimens were processed and tested with Solana Strep Complete Assay. The leftover swab transport media was shipped to the central location for an additional culture and NAAT testing.

A specimen was recorded as positive for either Streptococcus pyoqenes or Streptococcus dysgalactiae if either the culture or the FDA-cleared NAAT was positive, respectively.

Two thousand six hundred eighty-eight (2688) fresh throat swab specimens were tested using the algorithm described above (dual culture, FDA-cleared NAAT and Solana Strep Complete Assay). Two (2) specimens were repeatedly invalid when tested with the Solana® Strep Complete Assay (0.07%). These specimens have been removed from additional analysis. The table below details the combined results for Streptococcus pyogenes for the remaining two thousand six hundred eighty-six (2686).

Combined Clinical Sites' Results for Streptococcus pyogenes
Combined Culture and NAAT Result
Solana Strep Complete
AssayPositiveNegativeTotal
Positive47525500
Negative621802186
Total48122052686
95% CI
Sensitivity475/48198.8%97.3% to 99.4%
Specificity2180/220598.9%98.3% to 99.2%
Site 1- Streptococcus pyogenes Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive90494
Negative2679681
Total92683775
95% CI
Sensitivity90/9297.8%92.4% to 99.4%
Specificity679/68399.4%98.5% to 99.8%
Site 2 - Streptococcus pyogenes Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive84690
Negative1510511
Total85516601
95% CI
Sensitivity84/8598.8%93.6% to 99.8%
Specificity510/51698.8%97.5% to 99.5%
Site 3- Streptococcus pyogenes Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive1003103
Negative3492495
Total103495598
95% CI
Sensitivity100/10397.191.8% to 99.0%
Specificity492/49599.4%98.2% to 99.8%
Site 4- Streptococcus pyogenes Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive831295
Negative0254254
Total83266349
95% CI
Sensitivity83/83100%95.6% to 100%
Specificity254/26695.5%92.3% to 97.4%
Site 5- Streptococcus pyogenes Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive1180118
Negative0245245
Total118245363
95% CI
Sensitivity118/118100%96.8% to 100%
Specificity245/245100%98.5% to 100%

20

Quidel Corporation

510(k) Summary

Two thousand six hundred eighty-eight (2688) fresh throat swab specimens were tested using the algorithm described above (dual culture, FDA-cleared NAAT and Solana Strep

21

Complete Assay). Two (2) specimens were repeatedly invalid when tested with the Solana® Strep Complete Assay (0.07%). The table below details the combined results for Streptococcus dysgalactiae for the remaining two thousand six hundred eighty-six (2686).

Combined Clinical Sites' Results for Streptococcus dysgalactiae
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive781492
Negative025942594
Total7826082686
95% CI
Sensitivity78/78100%95.3% to 100%
Specificity2594/260899.5%99.1% to 99.7%
Site 1 - Streptococcus dysgalactiae Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive32436
Negative0739739
Total32743775
95% CI
Sensitivity32/32100%89.3% to 100%
Specificity739/74399.598.6% to 99.8%
Site 2 - Streptococcus dysgalactiae Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive16521
Negative0580580
Total16585601
95% CI
Sensitivity16/16100%80.6% to 100%
Specificity580/58599.1%98.0% to 99.6%
Site 3- Streptococcus dysgalactiae Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive26430
Negative0568568
Total26572598
95% CI
Sensitivity26/26100%87.1% to 100%
Specificity568/57299.3%98.2% to 99.7%
Site 4- Streptococcus dysgalactiae Results
Combined Culture and NAAT Result
Solana® Strep Complete
AssayPositiveNegativeTotal
Positive202
Negative0347347
Total2347349
95% CI
Sensitivity2/2100%34.2% to 100%
Specificity347/347100%98.9% to 100%
Site 5- Streptococcus dysgalactiae Results
Combined Culture and NAAT Result
Solana®
Strep Complete
AssayPositiveNegativeTotal
Positive213
Negative0360360
Total2361363
95% CI
Sensitivity2/2100%34.2% to 100%
Specificity360/36199.7%98.4% to 100%

22

All pyogenic Group C and Group G streptococcal species found during this assay were Group C and G S. dysgalactiae.

  • b. Clinical specificity:
    See Section 3a.

  • Other clinical supportive data (when a. and b. are not applicable): ﻥ
    Not applicable

    1. Clinical cut-off:
      Not applicable
    1. Expected values:
      The prevalence of Streptococcus pyogenes (Group A β-hemolytic Streptococcus) and Streptococcus dysgalactiae (pyogenic Group C and G β-hemolytic Streptococcus) with the Solana Strep Complete Assay has been calculated based on the age of the patient.

23

Two (2) specimens were invalid when tested with the Solana® Strep Complete Assay (0.07%) (in both the initial and repeat test no process control was detected) and have been removed from the Expected Values table. The table below presents the data for the remaining two thousand six hundred eighty-six (2686) specimens.

The overall incidence of Streptococcus pyogenes or Streptococcus dysgalactiae in patients tested during this study based on culture results alone was 16.0% (431/2686) for Streptococcus pyoqenes and 2.4%(65/2686) for Streptococcus dysgalactiae. The overall incidence of Streptococcus pyogenes or Streptococcus dysgalactiae in patients tested during this study based on a combination of culture results and another FDAcleared NAAT assay was 17.9% (481/2686) for Streptococcus pyogenes and 2.9% (78/2686) for Streptococcus dysqalactiae.

Combined Study Prevalence (2686)
Streptococcus pyogenesStreptococcus dysgalactiae
AgeTotal #Total PositivePrevalenceTotal #Total PositivePrevalence
≤ 2 years158117.0%15831.9%
3 to 12 years118933628.3%1189121.0%
13 to 21 years556509.0%556386.8%
≥ 22 years78310313.2%783395.0%
Overall268648117.9%2686782.9%

N. Other Supportive Instrument Performance Characteristics Data Not Covered In The "Performance Characteristics" Section above:

Instrument: Solana™ Instrument

O. System Descriptions:

    1. Modes of Operation:
      The Solana instrument heats each reaction tube to 64°C. If present, the target sequence is amplified by S. pyogenes and/or S. dysgalactiae specific primers and detected by S. pyogenes and/or S. dysgalactiae specific fluorescence probes included in the Reaction Tube. Each probe has a florescent dye of specific wavelength. The target probes are labeled with a quencher on one end and a fluorophore on the other end. In addition, the target probes carry a ribonucleic acid. Upon annealing to the respective amplicons, the fluorescence probes are cleaved by RNaseH2 and the fluorescence signal increases due

24

to physical separation of fluorophore from quencher. The Solana instrument measures and interprets the fluorescent signal, using on-board method-specific algorithms. Solana instrument will then report the test results to the user on its display screen, and it can print out the results via a printer.

2. Software:

FDA has reviewed applicant's Hazard Analysis and software development processes for this line of product types:

Yes __________________________________________________________________________________________________________________________________________________________________________ No ___________________________________________________________________________________________________________________________________________________________________________

P. Proposed Labeling:

The labeling is sufficient and it satisfies the requirements of 21 CFR Part 809.10, 21 CFR 801.109, and the special controls.