K Number
K211342
Device Name
Sofia 2 Campylobacter FIA
Manufacturer
Date Cleared
2021-11-23

(204 days)

Product Code
Regulation Number
866.3110
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Sofia 2 Campylobacter FIA employs immunofluorescence for the rapid qualitative detection of a Campylobacter-specific antigen in human fecal specimens. Sofia 2 Campylobacter FIA is designed to detect C. jejuni, C. coli, C. lari and C. upsalients with signs and symptoms of gastroenteritis. The test is intended for use with preserved fecal specimens in transport media and unpreserved fecal specimens. Test results should be considered in conjunction with clinical findings and patient history.
Device Description
The Sofia 2 Campylobacter FIA employs immunofluorescence technology that is used with Sofia 2 for the rapid qualitative detection of Campylobacter jejuni, Campylobacter lari, and Campylobacter upsaliensis specific antigens in fecal samples. The patient's sample is placed in the Specimen Tube containing the Specimen Solution to dilute, making the antigenic components more accessible to the specific antibodies. An aliquot of the diluted sample is dispensed through a filter to remove particulates, making them more compatible for testing, into the Test Cassette sample well. From the sample well, the sample migrates through a test strip containing various unique chemical environments. If Campylobacter jejuni, Campylobacter coli, Campylobacter lari, or Campylobacter upsaliensis specific antigens are present, they will be bound by antibodies coupled to fluorescent microparticles that migrate through the test strip. The fluorescent microparticles containing bound proteins will be captured by antibodies at a defined location on the test strip where they are detected by Sofia 2. If Campylobacter jejuni, Campylobacter coli, Campylobacter lari, or Campylobacter upsaliensis specific antigens are not present, the fluorescent microparticles will not be trapped by the capture antibodies nor detected by Sofia 2. The Test Cassette is placed inside of Sofia 2 for automatically timed development (WALK AWAY Mode), or pre-incubated on the bench top prior to loading into Sofia 2 (READ NOW Mode), where Sofia 2 will scan, measure, and interpret the immunofluorescent signal using method-specific algorithms. Sofia 2 will display the test results (Positive, Negative, or Invalid) on the screen. The fluorescence signal obtained with this assay is invisible to the unaided eye. The test results can only be obtained with the proper use of Sofia 2.
More Information

Not Found

No
The device description mentions "method-specific algorithms" for interpreting the immunofluorescent signal, but there is no mention of AI, ML, or deep learning. The performance studies and device description focus on traditional analytical and clinical validation methods.

No.
The device is a diagnostic test; it detects a Campylobacter-specific antigen to aid in the diagnosis of gastroenteritis, rather than treating or preventing a disease.

Yes

The device detects a Campylobacter-specific antigen in human fecal specimens to identify the presence of C. jejuni, C. coli, C. lari, and C. upsalients in individuals with symptoms of gastroenteritis. This process directly aids in the diagnosis of Campylobacter infection.

No

The device description clearly outlines a system that includes a Test Cassette (hardware) and the Sofia 2 instrument (hardware) which performs the scanning, measurement, and interpretation. While software is involved in the interpretation, it is integral to a hardware-based system.

Based on the provided information, the Sofia 2 Campylobacter FIA is indeed an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use explicitly states that the device is for the "rapid qualitative detection of a Campylobacter-specific antigen in human fecal specimens." This is a classic definition of an in vitro diagnostic test, as it analyzes a biological sample (fecal specimen) outside of the body to diagnose or detect a disease or condition (Campylobacter infection).
  • Device Description: The description details how the test works by analyzing the fecal sample using immunofluorescence technology to detect specific antigens. This process is performed "in vitro" (in glass or outside the body).
  • Performance Studies: The document includes extensive performance studies (Limit of Detection, Inclusivity, Cross Reactivity, Clinical Studies, etc.) which are standard requirements for demonstrating the analytical and clinical performance of an IVD.
  • Predicate Device: The mention of a "Predicate Device" (K191456; CAMPYLOBACTER QUIK CHEK™) is a strong indicator that this device is being compared to a previously cleared IVD, a common practice in the regulatory pathway for new IVDs.

Therefore, all the key elements point to the Sofia 2 Campylobacter FIA being an In Vitro Diagnostic device.

N/A

Intended Use / Indications for Use

Sofia 2 Campylobacter FIA employs immunofluorescence for the rapid qualitative detection of a Campylobacter-specific antigen in human fecal specimens. Sofia® 2 Campylobacter FIA is designed to detect C. jejuni, C. coli, C. lari and C. upsaliensis from patients with signs and symptoms of gastroenteritis. The test is intended for use with preserved fecal specimens in transport media and unpreserved fecal specimens. Test results should be considered in conjunction with clinical findings and patient history.

Product codes

LQP, KHO

Device Description

The Sofia 2 Campylobacter FIA employs immunofluorescence technology that is used with Sofia 2 for the rapid qualitative detection of Campylobacter jejuni, Campylobacter lari, and Campylobacter upsaliensis specific antigens in fecal samples.

The patient's sample is placed in the Specimen Tube containing the Specimen Solution to dilute, making the antigenic components more accessible to the specific antibodies. An aliquot of the diluted sample is dispensed through a filter to remove particulates, making them more compatible for testing, into the Test Cassette sample well. From the sample well, the sample migrates through a test strip containing various unique chemical environments. If Campylobacter jejuni, Campylobacter coli, Campylobacter lari, or Campylobacter upsaliensis specific antigens are present, they will be bound by antibodies coupled to fluorescent microparticles that migrate through the test strip. The fluorescent microparticles containing bound proteins will be captured by antibodies at a defined location on the test strip where they are detected by Sofia 2. If Campylobacter jejuni, Campylobacter coli, Campylobacter lari, or Campylobacter upsaliensis specific antigens are not present, the fluorescent microparticles will not be trapped by the capture antibodies nor detected by Sofia 2.

The Test Cassette is placed inside of Sofia 2 for automatically timed development (WALK AWAY Mode), or pre-incubated on the bench top prior to loading into Sofia 2 (READ NOW Mode), where Sofia 2 will scan, measure, and interpret the immunofluorescent signal using method-specific algorithms. Sofia 2 will display the test results (Positive, Negative, or Invalid) on the screen.

The fluorescence signal obtained with this assay is invisible to the unaided eye. The test results can only be obtained with the proper use of Sofia 2.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

human fecal specimens

Indicated Patient Age Range

Subjects ranged in age between 2 years to over 60 years.

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)

Limit of Detection (LoD): The LoD for Sofia 2 Campylobacter FIA was determined for four Campylobacter species in fecal matrix and in Cary Blair and C&S transport media. The LoD ranged from 9.82 x 10^4 to 5.21 x 10^6 colony forming units (cfu)/mL in fecal matrix, 1.57 x 10^5 cfu/mL in Cary Blair medium, and 1.50 x 10^5 to 2.71x 10^6 cfu/mL in C&S medium.

Inclusivity (Analytical Reactivity): Analytical reactivity was demonstrated using 17 additional strains of Campylobacter, including clinical isolates. Each strain was spiked into negative fecal matrix at 2-3x the LoD of the corresponding reference strain, with concentrations ranging from 2.95 x 10^5 to 1.44 x 10^7 cfu/mL. All strains showed reactivity. Additional inclusivity testing for C. coli, C. lari, and C. upsaliensis showed positive results at concentrations below the established LoD of reference strains.

Cross Reactivity/Microbial Interference: Evaluated with 48 bacterial and fungal microorganisms and 24 viral isolates. No cross-reactivity observed, with the exception of Campylobacter helveticus (no cross-reactivity at 1.98x10^5 CFU/mL). No microbial interference was observed when pre-mixed with C. jejuni at 2-3x LoD.

Interfering Substances: Several prescription and over-the-counter products and endogenous substances were evaluated. None interfered with the assay at the levels tested.

Specimen Storage and Stability: Neat, unpreserved fecal specimens were stable for up to 96 hours refrigerated (2°C to 8°C) or at room temperature (15°C to 30°C), and up to 13 days when frozen (90% positivity (C. coli, C. upsaliensis: 100%; C. lari in Cary Blair: 99%). Negative samples consistently yielded expected negative results.

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

Sensitivity = 100% (8/8) (95% CI=67.6% to 100%)
Specificity = 99.3% (797/803) (95% CI=98.4% to 99.7%)

Predicate Device(s):

CAMPYLOBACTER QUIK CHEK™ (K191456)

Reference Device(s):

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 866.3110

Campylobacter fetus serological reagents.(a)
Identification. Campylobacter fetus serological reagents are devices that consist of antisera conjugated with a fluorescent dye used to identifyCampylobacter fetus from clinical specimens or cultured isolates derived from clinical specimens. The identification aids in the diagnosis of diseases caused by this bacterium and provides epidemiological information on these diseases.Campylobacter fetus is a frequent cause of abortion in sheep and cattle and is sometimes responsible for endocarditis (inflammation of certain membranes of the heart) and enteritis (inflammation of the intestines) in humans.(b)
Classification. Class I (general controls).

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November 23, 2021

Quidel Corporation Michelle Bodien Director, Regulatory Affairs 10165 McKellar Court San Diego, California 92121

Re: K211342

Trade/Device Name: Sofia 2 Campylobacter FIA Regulation Number: 21 CFR 866.3110 Regulation Name: Campylobacter fetus Serological Reagents Regulatory Class: Class I. reserved Product Code: LQP, KHO Dated: April 30, 2021 Received: May 3, 2021

Dear Michelle Bodien:

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. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. 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 Part

1

801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

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 https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Ribhi Shawar, Ph.D. (ABMM) Chief General Bacteriology and Antimicrobial Susceptibility Branch Division of Microbiology Devices OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known)

Device Name

Indications for Use (Describe)

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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510(k) Summary

Submitter

Ouidel Corporation 10165 McKellar Court San Diego, CA 92121 Telephone: (800) 874-1517

Submission Contact

Michelle Bodien Director, Regulatory Affairs (210) 740-5756

Date Prepared

November 22, 2021

Proprietary and Established Names

Sofia 2 Campylobacter FIA

Common Name

Campylobacter spp. rapid test

Classification

Product CodeClassificationRegulatory SectionDescription
LQP121 CFR 866.3110Campylobacter spp.

Panel

Microbiology

Predicate Device

CAMPYLOBACTER QUIK CHEK™ (K191456)

Device Description

The Sofia 2 Campylobacter FIA employs immunofluorescence technology that is used with Sofia 2 for the rapid qualitative detection of Campylobacter jejuni, Campylobacter lari, and Campylobacter upsaliensis specific antigens in fecal samples.

The patient's sample is placed in the Specimen Tube containing the Specimen Solution to dilute, making the antigenic components more accessible to the specific antibodies. An aliquot of the diluted sample is dispensed through a filter to remove particulates, making them more compatible for testing, into the Test Cassette sample well. From the sample well, the sample migrates through a test strip containing various unique chemical environments. If Campylobacter jejuni, Campylobacter coli, Campylobacter lari, or Campylobacter upsaliensis specific antigens are present, they will be bound by antibodies coupled to fluorescent microparticles that migrate through the test strip. The fluorescent microparticles containing bound proteins will be captured by antibodies at a defined location on the test strip where they are detected

Sofia 2 Campylobacter FIA 510(k)

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by Sofia 2. If Campylobacter jejuni, Campylobacter coli, Campylobacter lari, or Campylobacter upsaliensis specific antigens are not present, the fluorescent microparticles will not be trapped by the capture antibodies nor detected by Sofia 2.

The Test Cassette is placed inside of Sofia 2 for automatically timed development (WALK AWAY Mode), or pre-incubated on the bench top prior to loading into Sofia 2 (READ NOW Mode), where Sofia 2 will scan, measure, and interpret the immunofluorescent signal using method-specific algorithms. Sofia 2 will display the test results (Positive, Negative, or Invalid) on the screen.

The fluorescence signal obtained with this assay is invisible to the unaided eye. The test results can only be obtained with the proper use of Sofia 2.

Intended Use

Sofia 2 Campylobacter FIA employs immunofluorescence for the rapid qualitative detection of a Campylobacter-specific antigen in human fecal specimens. Sofia 2 Campylobacter FIA is designed to detect C. jejuni, C. coli, C. lari and C. upsalients with signs and symptoms of gastroenteritis. The test is intended for use with preserved fecal specimens in transport media and unpreserved fecal specimens. Test results should be considered in conjunction with clinical findings and patient history.

| Features | Proposed Device
Sofia 2 Campylobacter FIA | Predicate Device
CAMPYLOBACTER QUIK CHEKTM
(K191456) |
|-----------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Intended Use | Sofia 2 Campylobacter FIA employs
immunofluorescence for the rapid
qualitative detection of a
Campylobacter -specific antigen in
human fecal specimens. Sofia® 2
Campylobacter FIA is designed to
detect C. jejuni, C. coli, C. lari and C.
upsaliensis from patients with signs and
symptoms of gastroenteritis. The test is
intended for use with preserved fecal
specimens in transport media and
unpreserved fecal specimens. Test
results should be considered in
conjunction with clinical findings and
patient history. | The CAMPYLOBACTER QUIK
CHEK test is a rapid membrane
enzyme-linked immunosorbent assay
for the qualitative detection of a
Campylobacter -specific antigen in
human fecal specimens. The
CAMPYLOBACTER QUIK CHEK
test is designed to detect C. jejuni, C.
coli, C. lari , and C. upsaliensis from
patients with signs and symptoms of
gastroenteritis. The test is intended for
use with preserved fecal specimens in
transport media and unpreserved fecal
specimens. Test results should be
considered in conjunction with
clinical findings and patient history. |
| Automated
Analysis | Yes | No |
| Qualitative | Yes | Same |
| Analyte | Campylobacter -specific antigens ( C.
jejuni, C. coli, C. lari and C.
upsaliensis ) | Same |

Comparison with Predicate

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| Features | Proposed Device
Sofia 2 Campylobacter FIA | Predicate Device
CAMPYLOBACTER QUIK CHEKTM
(K191456) |
|-------------------|--------------------------------------------------------------------------------------------------|------------------------------------------------------------|
| Specimen Type | Human fecal specimens (unpreserved)
or preserved in Cary Blair and C&S
Transport Media | Same |
| Test Principle | Immunofluorescence device | Immunosorbent assay |
| Format | Lateral-flow test cassette | Membrane Enzyme Linked
Immunosorbent Assay (ELISA) |
| Antibodies Used | Monoclonal and polyclonal antibodies
that are specific to Campylobacter
antigen | Same |
| External Controls | Test kit contains Positive
(Campylobacter-specific antigen) and
Negative Control Solutions | Same |
| Time to Result | 15 minutes | C. jejuni | $9.82 x 10^4$ | $1.57 x 10^5$ | $1.50 x 10^5$ |
| C. coli | $1.15 x 10^6$ | $1.59 x 10^6$ | $9.02 x 10^5$ |
| C. lari | $2.00 x 10^6$ | $1.75 x 10^6$ | $2.25 x 10^6$ |
| C. upsaliensis | $5.21 x 10^6$ | $5.21 x 10^6$ | $2.71 x 10^6$ |

Table 1. Limits of Detection
------------------------------------

cfu/mL = colony forming units per milliliter

*The levels of bacteria were determined by limiting dilution, bacterial culture, and colony counting to give cfu/mL.

Inclusivity (Analytical Reactivity)

Analytical reactivity for Sofia 2 Campylobacter FIA was demonstrated using 17 additional strains of Campylobacter, including clinical isolates. Each strain was spiked into negative fecal matrix at 2-3x the

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LoD of the corresponding reference strain used to confirm the LoD. At 2-3x LoD, samples were at concentrations ranging from 2.95 x 106 to 1.44 x 107 colony forming units (cfu)/mL (Table 2).

Campylobacter speciesStrainLevel Detected*
Campylobacter jejuniCCUG 69512.95 x 105 cfu/mL
CCUG 120812.95 x 105 cfu/mL
CCUG 294112.95 x 105 cfu/mL
CCUG 381062.95 x 105 cfu/mL
Campylobacter jejuni subspecies doyleiCCUG 245672.95 x 105 cfu/mL
Campylobacter coliCCUG 109563.45 x 106 cfu/mL
CCUG 177553.45 x 106 cfu/mL
CCUG369943.45 x 106 cfu/mL
CCUG 531383.45 x 106 cfu/mL
Campylobacter lari2015/21896.00 x 106 cfu/mL
2015/16576.00 x 106 cfu/mL
2015/29836.00 x 106 cfu/mL
2016/1130H6.00 x 106 cfu/mL
Campylobacter upsaliensis2016/19501.44 x 107 cfu/mL
2016/28261.44 x 107 cfu/mL
2017/03491.44 x 107 cfu/mL
2018/16691.44 x 107 cfu/mL

Table 2. Analytical Reactivity

cfu/mL = colony forming units per milliliter

*The levels of bacteria were determined by limiting dilution, bacterial culture, and colony counting to give cfu/mL.

Additional inclusivity testing was performed for select strains of C. coli, C. lari, and C. upsaliensis to verify the lowest concentration of each strain that is reactive in the Sofia 2 Campylobacter FIA. Four-fold serial dilutions for each of the targeted strains were prepared from stock culture slurries using negative fecal matrix and tested in replicates of three in the assay. The qualitative results were used to determine the lowest detectable level in the series, where 3/3 results were positive (Table 3). The results demonstrated that these strains produced positive results in the assay at concentrations below the limit of detection established with the corresponding reference strains. Note: these results are not a true limit of detection and are used to demonstrate inclusivity of these strains at low concentrations of bacteria only.

Table 3. Dilution Testing - Inclusivity Strains

| Species Tested | Dilution | Concentration
(cfu/mL) | N | Pos | Neg | % Pos. |
|------------------------------------------------------------------|--------------|---------------------------|---|-----|-----|--------|
| Campylobacter coli
CCUG 53138
Stock $2.2 x 10^7$
CFU/mL | Stock slurry | $2.2 x 10^7$ | 3 | 3 | 0 | 100 |
| | 1:4 | $5.5 x 10^6$ | 3 | 3 | 0 | 100 |
| | 1:16 | $1.375 x 10^6$ | 3 | 3 | 0 | 100 |
| | 1:64 | $3.438 x 10^5$ | 3 | 3 | 0 | 100 |
| | 1:256 | $8.594x 10^4$ | 3 | 3 | 0 | 100 |
| | 1:1024 | $2.148 x 10^4$ | 3 | 0 | 3 | 0 |

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| Species Tested | Dilution | Concentration
(cfu/mL) | N | Pos | Neg | % Pos. |
|------------------------------------------------------------------------|--------------|---------------------------|---|-----|-----|--------|
| | 1:4096 | $5.371 x 10^3$ | 3 | 0 | 3 | 0 |
| Campylobacter lari
2015/2189
Stock 1.55 x 107
CFU/mL | Stock slurry | $1.55 x 10^7$ | 3 | 3 | 0 | 100 |
| | 1:4 | $3.875 x 10^6$ | 3 | 3 | 0 | 100 |
| | 1:16 | $9.688 x 10^5$ | 3 | 3 | 0 | 100 |
| | 1:64 | $2.422 x 10^5$ | 3 | 3 | 0 | 100 |
| | 1:256 | $6.055 x 10^4$ | 3 | 3 | 0 | 100 |
| | 1:1024 | $1.514 x 10^4$ | 3 | 0 | 3 | 0 |
| | 1:4096 | $3.784 x 10^3$ | 3 | 0 | 3 | 0 |
| Campylobacter lari
2016/1130H
Stock 1.4 x 107
CFU/mL | Stock slurry | $1.4 x 10^7$ | 3 | 3 | 0 | 100 |
| | 1:4 | $3.5 x 10^6$ | 3 | 3 | 0 | 100 |
| | 1:16 | $8.75 x 10^5$ | 3 | 3 | 0 | 100 |
| | 1:64 | $2.188 x 10^5$ | 3 | 3 | 0 | 100 |
| | 1:256 | $5.469 x 10^4$ | 3 | 0 | 3 | 0 |
| | 1:1024 | $1.367 x 10^4$ | 3 | 0 | 3 | 0 |
| | 1:4096 | $3.418 x 10^3$ | 3 | 0 | 3 | 0 |
| Campylobacter
upsaliensis
2016/1950
Stock 8.4 x 107
CFU/mL | Stock slurry | $8.4 x 10^7$ | 3 | 3 | 0 | 100 |
| | 1:4 | $2.1 x 10^7$ | 3 | 3 | 0 | 100 |
| | 1:16 | $5.25 x 10^6$ | 3 | 3 | 0 | 100 |
| | 1:64 | $1.313 x 10^6$ | 3 | 3 | 0 | 100 |
| | 1:256 | $3.281 x 10^5$ | 3 | 2 | 1 | 67 |
| | 1:1024 | $8.203 x 10^4$ | 3 | 0 | 3 | 0 |
| | 1:4096 | $2.051 x 10^4$ | 3 | 0 | 3 | 0 |

Cross Reactivity/Microbial Interference,

The cross reactivity of the Sofia 2 Campylobacter FIA was evaluated with a total of 48 bacterial and fungal microorganisms and 24 viral isolates. None of the microorganisms or viruses showed cross reactivity in the assay at the concentrations tested with the exception of Campylobacter helveticus. Additional C. helveticus concentrations were tested and cross-reactivity was no longer observed at 1.98x105 CFU/mL. For microbial interference testing, the same microorganisms and viruses were pre-mixed with C. jejuni at 2-3x LoD and tested in the assay. None showed any signs of microbial interference in the assay.

Interfering Substances

Several prescription and over-the-counter (OTC) products and endogenous substances were evaluated with the Sofia 2 Campylobacter FIA. Each substance was tested in the presence and absence of C. jejuni at 2-3x LoD. None of the substances interfered with the assay at the levels tested.

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Specimen Storage and Stability

The results of this study demonstrated that neat, unpreserved fecal specimens were stable for up to 96 hours when stored refrigerated (2°C to 8°C) or at room temperature (15°C to 30°C) or up to 13 days when frozen (Table 5. Reproducibility Study Inter- Laboratory Agreement | | |
|--|-------------------------------------------------------------------|--|--|
| | | | |

*Bacteria not detected/total

**Bacteria detected/total

Prospective Clinical Study

The performance of the Sofia 2 Campylobacter FIA was compared to culture and identification in a multicenter prospective clinical study. One hundred ninety-one (191) fresh, neat specimens and six hundred twenty (620) fresh specimens in transport media were evaluated. Sixty-two percent (62%) of the subjects were female and thirty-eight percent (38%) were male. Subjects ranged in age between 2 years to over 60 years. The results of the prospective clinical study are shown in Table 6. The eight (8) consensus positive specimens (Sofia Positive/ Culture Positive) were identified as Campylobacter jejuni by species-specific RT-PCR and bi-directional sequence analysis. Of the six (6) discordant specimens (Sofia Positive/ Culture Negative), three specimens were identified as positive for C. jejuni, two were C. upsaliensis, and one was C. coli by species-specific RT-PCR and bi-directional sequence analysis.

Table 6. Sofia 2 Campylobacter FIA Performance Compared to Culture with Fresh Specimens
Culture
PosNegTotalSensitivity = 100% (8/8)(95% CI=67.6% to 100%)
Sofia Pos86%14Specificity = 99.3% (797/803)
Sofia Neg0797797(95% CI=98.4% to 99.7%)
Total:oc803811
  • Of the 6 culture negative - Sofia 2 Campylobacter FIA positive samples, all 6 were confirmed as positive by species-specific RT-PCR and bi-directional sequence analysis.

Archived Clinical Study

Seventy (70) frozen, characterized specimens were tested by the Sofia 2 Campylobacter FIA at a central laboratory including 35 culture-negative specimens preserved in transport media. Of the 35 positive specimens, there were a total of 11 specimens in transport media and 24 neat fecal specimens. The positive specimens were Campylobacter spp. culture-positive and were further characterized by RT-PCR and bi-directional sequencing to assess if weak positives were included in the archived study and determine performance of the Sofia 2 Campylobacter FIA with such specimens All 35 specimens tested

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positive for Campylobacter spp. by all methods, vielding 100% correlation with all test methods. Thirty specimens were identified as positive for C. jejuni and five were C. coli. Additionally, all 35 negative specimens yielded 100% correlation with all test methods.

Rare Isolates Testing

A study was conducted to evaluate the performance of the Sofia 2 Campylobacter FIA with less common analytes not represented during the clinical studies. Five (5) strains of each species of C. coli, C. lari, and C. upsaliensis were prepared at concentrations of 1-2 times the limit of detection of the corresponding reference strains in neat fecal matrix in Cary Blair transport medium, and fecal matrix in C&S transport medium and tested in the assay over a period of three days. Each strain was detected by the assay with >90% positivity (Table 7). Additionally, a negative sample was prepared in each matrix and tested in parallel, and the expected negative results were obtained each day.

| | Concentration
Tested (CFU/mL) | n | Number of Negatives and Positives | | | | | | % Positivity | | | |
|----------------|----------------------------------|----|-----------------------------------|-------|-------|-------|-------|-------|--------------|----------|----------|-------|
| Sample | | | Day 1 | | Day 2 | | Day 3 | | Day
1 | Day
2 | Day
3 | Total |
| | | | # Neg | # Pos | # Neg | # Pos | # Neg | # Pos | | | | |
| Fecal Matrix | | | | | | | | | | | | |
| Negative | N/A | 30 | 30 | 0 | 30 | 0 | 30 | 0 | 0 | 0 | 0 | 0 |
| C. coli | 2.30 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| C. lari | 4.00 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| C. upsaliensis | 9.58 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| Cary Blair | | | | | | | | | | | | |
| Negative | N/A | 30 | 30 | 0 | 30 | 0 | 30 | 0 | 0 | 0 | 0 | 0 |
| C. coli | 3.06 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| C. lari | 3.50 x 10^6 | 30 | 1 | 29 | 0 | 30 | 0 | 30 | 97 | 100 | 100 | 99 |
| C. upsaliensis | 5.20 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| C&S | | | | | | | | | | | | |
| Negative | N/A | 30 | 30 | 0 | 30 | 0 | 30 | 0 | 0 | 0 | 0 | 0 |
| C. coli | 1.80 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| C. lari | 2.50 X 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |
| C. upsaliensis | 4.66 x 10^6 | 30 | 0 | 30 | 0 | 30 | 0 | 30 | 100 | 100 | 100 | 100 |

Table 7 Sofia 2 Campylobacter FIA Performance With Rare Isolates