ADVIA Centaur ADVIA Centaur XP

Immunoassay Systems

Rubella M (Rub M)
Assay for the Detection of IgM Antibodies to Rubella Virus
Assay Summary
Sample Type Sample Volume Calibrator Assay Range Serum, Heparinized Plasma, EDTA Plasma 20 L Rub M 0.0 15.00 Index

Contents
REF 02633319 (117733) Contents 1 ReadyPack primary reagent pack containing ADVIA Centaur Rub M Lite Reagent and Solid Phase ADVIA Centaur Rub M Master Curve card 1 vial Rub M Low Calibrator 1 vial Rub M High Calibrator ADVIA Centaur Rub M Calibrator Assigned Value card Number of Tests 50

Intended Use
The ADVIA Centaur and ADVIA Centaur XP Rubella IgM assay is an IgM antibody capture microparticle direct chemiluminometric in vitro diagnostic immunoassay for the qualitative detection of IgM antibodies to the rubella virus in serum or plasma (EDTA, heparin) as an aid in the presumptive diagnosis of current or recent infection with rubella.
WARNING: The calculated values for rubella IgM in a given specimen, as determined by assays from different manufacturers, can vary due to differences in assay methods and reagent specificity. The results reported by the laboratory to the physician must include the identity of the rubella IgM assay used. Values obtained with different assay methods cannot be used interchangeably. The reported IgM level cannot be correlated to an endpoint titer.

Materials Required but Not Provided

REF 01137199 (112351) or 03773025 00347629 (117734) 07948423 (110314) Description ADVIA Centaur Wash 1 ADVIA Centaur Wash 1 * Contents 2 x 1500 mL/pack 2 x 2500 mL/pack 2 x 2.7 mL Negative Control 2 x 2.7 mL Positive Control Expected Value card 2 ReadyPack ancillary reagent packs containing 10 mL/pack

ADVIA Centaur Rub M quality control material

ADVIA Centaur Multi-Diluent 2

*for use with systems with 2500 mL capacity

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Rub M Summary and Explanation of the Test

ADVIA Centaur and ADVIA Centaur XP Systems

Rubella is a member of the togaviridae family. Primary infections are generally mild, with symptoms such as a mild rash, low-grade fever, and lymphadenopathy. In contrast, primary infections during pregnancy can pass transplacentally to the fetus and can lead to fetal death or congenital rubella syndrome (CRS); the risk of fetal infection is greatest during the first trimester of pregnancy. Babies born with CRS typically exhibit low birth weight, deafness, eye disease, mental retardation, and cardiac abnormalities. Rubella infections are difficult to diagnose from the appearance and symptoms of the patient alone, so laboratory analyses have become the diagnostic standard. Because of the difficulty of detecting rubella virus in the circulation, rubella infection is usually diagnosed using serological tests. The test results indicate the response of the patient's immune system to the virus.1 A primary infection of, or vaccination with, rubella almost always induces both an IgM and an IgG response. Within a few months, the IgM usually becomes undetectable, although it may persist for years in some individuals.2 The IgG may also decrease after its initial rise, but, in most people, remains at a protective level for years. Subsequent re-exposure to rubella can cause a rapid rise in the titer of specific IgG antibodies, but the IgM titer does not usually rise as well. It has been reported that exposure to certain other viruses can result in the appearance in the circulation of measurable amounts of rubella-specific IgM antibodies, but the mechanism behind this is unknown.3 Only one serological type of rubella virus is found in the population.4,5 Since the introduction of the rubella vaccine in the late 1960s, the incidence of CRS has dropped dramatically. However, outbreaks of rubella have still occurred and pose a potential risk to women of childbearing age.

Assay Principle
The ADVIA Centaur Rubella M assay is a sandwich immunoassay using direct, chemiluminometric technology. The anti-human IgMFc monoclonal antibody is covalently coupled to paramagnetic particles in the Solid Phase. In the Lite Reagent, the rubella virus antigen is labeled with acridinium ester. Antibody-antigen complexes will form if rubella IgM is present in the sample. The system automatically performs the following actions: Dispenses 20 L of sample and 335 L of Multi-Diluent 2 into a cuvette. Aspirates 20 L of diluted sample and dispenses it into a cuvette. Dispenses 250 L of Solid Phase and incubates the mixture for 18 minutes at 37C. Separates the Solid Phase from the mixture and aspirates the unbound reagent. Washes the cuvette with Wash 1. Dispenses 150 L Lite Reagent and incubates the mixture for 18 minutes at 37C. Separates the Solid Phase from the mixture and aspirates the unbound reagent. Washes the cuvette with Wash 1. Dispenses 300 L each of Acid Reagent and Base Reagent to initiate the chemiluminescent reaction. Reports results according to the selected option, as described in the system operating instructions or in the online help system.

A direct relationship exists between the amount of rubella IgM activity present in the patient sample and the amount of relative light units (RLUs) detected by the system. A result of reactive (positive) or nonreactive (negative) is determined according to the Cutoff Index Value established with the calibrators. Refer to Interpretation of Results for a description of the Cutoff Index Value calculation.
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Specimen Collection and Handling

Serum, heparinized plasma, or EDTA plasma are the recommended sample types for this assay. Do not use heat inactivated specimens. Do not use specimens with obvious microbial contamination. The performance of the ADVIA Centaur Rubella M assay has not been established with cadaver specimens or body fluids other than serum or plasma such as saliva, urine, amniotic, or pleural fluids. Handle all samples as if capable of transmitting disease. Test samples as soon as possible after collecting. Store samples at 2 to 8C if not tested immediately. Store specimens at 2 to 8C up to 7 days. Specimens may be stored on the clot. Freeze samples, devoid of red blood cells, at or below -20C for longer storage. Do not store in frost-free freezer. When 3 weakly positive samples and 9 negative samples were subject to 5 freeze/thaw cycles, no qualitative differences were observed. Thoroughly mix thawed samples and centrifuge for 10,000 x g for 10 minutes before using. Package and label samples for shipment in compliance with applicable federal and international regulations covering the transport of clinical samples and etiological agents. Samples maintained at room temperature up to 2 days or refrigerated up to 7 days demonstrated no qualitative differences. Store samples at 2 to 8C upon arrival. If shipment is expected to exceed 7 days, ship specimens frozen. Samples are free of fibrin or other particulate matter. Remove particulates by filtration or centrifugation at 1000 x g for 10 to 15 minutes. Samples are free of bubbles.

Before placing samples on the system, ensure that samples have the following characteristics:

Reagents
Store the reagents upright at 28C. Mix all primary reagent packs by hand before loading them onto the system. Visually inspect the bottom of the reagent pack to ensure that all particles are dispersed and resuspended. For detailed information about preparing the reagents for use, see the system operators guide. Reagent Pack Reagent ADVIA Centaur Lite Reagent Rub M ReadyPack primary reagent pack Solid Phase Volume 7.5 mL/ reagent pack Ingredients inactivated rubella virus antigen (strain HPV 77) (~0.27 g/mL) labeled with acridinium ester in buffer with preservatives anti-human IgM monoclonal antibody (~0.14 mg/mL) covalently coupled to paramagnetic particles in buffer with preservatives processed human plasma positive for rubella IgM antibodies with preservatives goat serum with sodium azide (0.1%) and preservatives Storage Stability 28C Until the expiration date on the pack label. For onboard stability, refer to Onboard Stability and Calibration Interval. 28C Until the expiration date on the pack label. For onboard stability, refer to Onboard Stability and Calibration Interval. 28C Until the expiration date on the vial or onboard8 hours. Until the expiration date on the pack label or 28 consecutive days after accessing the ancillary reagent pack.

12.5 mL/ reagent pack

Rub M calibrator vials

Calibrators

1.0 mL/ vial

ADVIA Centaur Multi-Diluent 2 ReadyPack ancillary reagent pack*

10.0 mL/ reagent pack

28C

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Rub M
Reagent Pack Reagent ADVIA Centaur Wash 1 * ADVIA Centaur Wash 1 * Rub M quality control material vials* * Controls

ADVIA Centaur and ADVIA Centaur XP Systems Volume Ingredients Storage Stability 1500 mL/ phosphate buffered saline 225C Until the expiration date on the vial pack with sodium azide or (< 0.1%) and surfactant onboard1 month. 2500 mL/ phosphate buffered saline 225C Until the expiration date on pack with sodium azide the vial (< 0.1%) and surfactant or onboard1 month. 2.7 mL/ processed human plasma 28C Until the expiration date on vial negative and positive for the vial rubella IgM antibodies or with preservatives onboard8 hours.

See Materials Required but Not Provided

CAUTION! POTENTIAL BIOHAZARD: Contains human source material. While each human serum or plasma

Safety data sheets (MSDS/SDS) available on www.siemens.com/diagnostics.

donor unit used in the manufacture of this product was tested by FDA-approved methods and found nonreactive for hepatitis B surface antigen (HBsAg), antibody to hepatitis C (HCV), and antibody to HIV-1/2, all products manufactured using human source material should be handled as potentially infectious. Because no test method can offer complete assurance that hepatitis B or C viruses, HIV, or other infectious agents are absent, these products should be handled according to established good laboratory practices.6-8

CAUTION: This device contains material of animal origin and should be handled as a potential carrier and transmitter of disease. NOTE: Sodium azide can react with copper and lead plumbing to form explosive metal azides. On disposal, flush reagents with a large volume of water to prevent the buildup of azides, if disposal in a drain is in compliance with federal, state, and local requirements.

For in vitro diagnostic use.

Loading Reagents
Ensure that the system has sufficient primary reagent packs. For detailed information about preparing the system, refer to the system operating instructions or to the online help system. Mix all primary reagent packs by hand before loading them onto the system. Visually inspect the bottom of the reagent pack to ensure that all particles are dispersed and resuspended. For detailed information about preparing the reagents for use, see the system operators guide. Load the ReadyPack primary reagent packs in the primary reagent compartment using the arrows on the packs as a placement guide. The system automatically mixes the primary reagent packs to maintain homogeneous suspension of the reagents. Load the Multi-Diluent 2 ancillary reagent pack in the ancillary reagent entry. For detailed information about loading reagents, refer to the system operating instructions or to the online help system.
NOTE: The Low and High Calibrators provided in this kit are matched to the ReadyPack primary reagent pack. Do not mix calibrator lots with different lots of reagent packs.

Onboard Stability and Calibration Interval

Onboard Stability 28 days Calibration Interval 14 days

Additionally, the ADVIA Centaur Rubella M assay requires a two-point calibration: when changing lot numbers of primary reagent packs when replacing system components when quality control results are repeatedly out of range

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NOTE:

Discard reagent packs at the end of the onboard stability interval. Do not use reagents beyond the expiration date.

Calibration
For detailed information about entering calibration values, refer to the system operating instructions or to the online help system.

Using Barcode Labels

Calibrator barcode labels are lot-number specific. Do not use barcode labels from one lot of calibrators with any other lot of calibrators. Use the ADVIA Centaur Rubella M Calibrator barcode labels to identify the Low and High Calibrator sample cups when performing the ADVIA Centaur Rubella M assay. Place the barcode label on the sample cup so that the readable characters on the side of the label are vertical on the sample cup.

Performing a Calibration
Each lot of calibrators contains a Calibrator Assigned Value card to facilitate entering the calibration values on the system. Enter the values using the barcode scanner or the keyboard.
NOTE: This procedure uses calibrator volumes sufficient to measure each calibrator in

duplicate.

1. Schedule the calibrators to the worklist. 2. Label two sample cups with calibrator barcode labels: one for the low and another for the high.
NOTE: Each drop from the calibrator vial is approximately 50 L.

3. Gently mix the Low and High Calibrators and dispense at least 4 to 5 drops into the appropriate sample cups. 4. Load the sample cups in a rack. 5. Place the rack in the sample entry queue. 6. Ensure that the assay and ancillary reagents are loaded. 7. Start the entry queue, if required.
NOTE: Dispose of any calibrator remaining in the sample cups after 8 hours. Do not refill sample cups when the contents are depleted; if required, dispense fresh calibrators.

Quality Control
Follow government regulations or accreditation requirements for quality control frequency. For quality control of the ADVIA Centaur Rubella M assay, use ADVIA Centaur Rubella M quality control material. Refer to the Expected Value card for the suggested expected values specific for the lot number of the positive and negative controls.

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Using Barcode Labels

ADVIA Centaur and ADVIA Centaur XP Systems

Control barcode labels are lot-number specific. Do not use barcode labels from one lot of controls with any other lot of controls. Use the ADVIA Centaur Rubella M quality control barcode labels to identify the positive and negative sample cups when performing the ADVIA Centaur Rubella M assay. Place the barcode label on the sample cup so that the readable characters on the side of the label are vertical on the sample cup.

Performing Quality Control

For detailed information about entering quality control values, refer to the system operating instructions or to the online help system. To monitor system performance and chart trends, as a minimum requirement, quality control samples should be assayed on each workshift that samples are analyzed. Quality control samples should also be assayed when performing a two-point calibration. Treat all quality control samples the same as patient samples.
NOTE: This procedure uses control volumes sufficient to measure each control in duplicate.

1. Schedule the quality control samples to the worklist. 2. Label two sample cups with quality control barcode labels: one for the positive and another for the negative.
NOTE: Each drop from the control vial is approximately 50 L.

3. Gently mix the quality control materials and dispense at least 4 to 5 drops into the appropriate sample cups. 4. Load the sample cups in a rack. 5. Place the rack in the sample entry queue. 6. Ensure that the assay reagents are loaded. 7. Start the entry queue, if required.
NOTE: Dispose of any quality control materials remaining in the sample cups after 8 hours. Do not refill sample cups when the contents are depleted; if required, dispense fresh quality control materials.

Taking Corrective Action

If the quality control results do not fall within the Expected Values or within the laboratorys established values, do not report results. Take the following actions: Verify that the materials are not expired. Verify that required maintenance was performed. Verify that the assay was performed according to the instructions for use. Rerun the assay with fresh quality control samples. If necessary, contact your local technical support provider or distributor for assistance.

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Sample Volume
This assay requires 20 L of sample for a single determination. This volume does not include the unusable volume in the sample container or the additional volume required when performing duplicates or other tests on the same sample. For detailed information about determining the minimum required volume, refer to Sample Volume Requirements in the ADVIA Centaur Reference Manual.

Assay Procedure
For detailed procedural information, refer to the system operating instructions or to the online help system.

Procedural Notes
Disposal
Dispose of hazardous or biologically contaminated materials according to the practices of your institution. Discard all materials in a safe and acceptable manner, and in compliance with all federal, state, and local requirements.

Interpretation of Results
For detailed information about how the system calculates results, refer to the system operating instructions or to the online help system. The system reports rubella IgM antibody results in Index Values and as reactive (positive), equivocal, or nonreactive (negative). Samples with a calculated value of less than 0.80 Index Value are considered negative for IgM antibodies to rubella virus. Samples with a calculated value greater than or equal to 0.80 Index Value and less than or equal to 0.99 Index Value are considered equivocal and must be repeated. If the results are equivocal again, then a second specimen should be obtained and tested. Samples with a calculated value greater than or equal to 1.00 Index Value are considered positive for IgM antibodies to rubella virus. The cutoff for the ADVIA Centaur Rubella M assay was verified based on results of Receiver-Operator characteristics (ROC) Curve and positive/negative predictive values generated from the results of the clinical studies. Sample results are invalid and must be repeated if the controls are out of range.

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Rub M Limitations

ADVIA Centaur and ADVIA Centaur XP Systems

The following information pertains to limitations of the assay: The ADVIA Centaur Rubella M assay is limited to the detection of IgM antibodies to rubella virus in human serum or plasma. Specimens taken early during the acute phase of infection may not contain detectable levels of IgM antibody to rubella virus. A negative result for IgM antibodies to rubella virus does not preclude a recent primary infection. In the absence of clinical symptoms or known exposure, a diagnosis of a primary rubella infection should not be based on a positive result alone. The specimen should be confirmed using another method before making the diagnosis. Do not use heat inactivated specimens. Do not use specimens with obvious microbial contamination. The performance of the ADVIA Centaur Rubella M assay has not been established with cord blood, neonatal specimens, cadaver specimens, or body fluids other than serum or plasma, such as saliva, urine, amniotic, or pleural fluids. The performance of the assay has not been established for populations of immunocompromised or immunosuppressed patients.
Demonstrate 10% change in results . . . up to 500 mg/dL of hemoglobin up to 1000 mg/dL of triglycerides up to 60 mg/dL of conjugated bilirubin up to 40 mg/dL of unconjugated bilirubin between 312 g/dL of protein up to 3 mg/mL of immunoglobulin M

Serum specimens that are . . . hemolyzed lipemic icteric hypo/hyperproteinemia hypergammaglobulinemia

Expected Values
The incidence of IgM antibody to the rubella virus varies among populations. Data was obtained on 950 samples from prenatal women and random individuals. Of these samples, 11 (1.1%) were positive, 12 (1.3%) were equivocal, and 927 (97.6%) were negative. As with all in vitro diagnostic assays, each laboratory should determine its own reference range(s) for the diagnostic evaluation of patient results.9
Population Prenatal women Random individuals N 585 365 Negative 576 (98.4%) 351 (96.2%) Equivocal 5 (0.9%) 7 (1.9%) Positive 4 (0.7%) 7 (1.9%)

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A D V IA C e n ta u r R u b e lla Ig M : O b s e rve d V a lu e s fo r V a rio u s S a m p le P o p u la tio n s

450

400

P re n a ta l (N = 5 8 5 ) H o sp ita l/C lin ic a l (N = 3 6 5 )

350

300

Frequency

250

200
T otal # of S am p les for A ll S ites = 9 50 C u toff Ind ex V alue = 1.0 0

150

100

50

0
0.00 - 0.12 0.12 - 0.23 0.24 - 0.35 0.36 - 0.47 0.48 - 0.59 0.60 - 0.71 0.72 - 0.83 0.84 - 0.95 0.96 - 1.07 1.08 - 1.19 1.20 - 1.31 1.32 - 1.43 1.44 - 1.55 1.56 - 1.67 1.68- 1.79 1.80 - 1.91 1.92 - 2.03 2.04 - 2.15 2.16 - 2.27 2.28 - 2.39 2.40 - 2.51 2.52 - 2.63 2.64 - 2.75 2.76 - 2.87 2.88 - 2.99 > 3.00

A D V IA C e n ta u r R u b e lla Ig M In d e x V a lu e s

Performance Characteristics
Sensitivity and Specificity
Relative Agreement The presence of rubella IgM antibody in 1054 frozen and fresh specimens was evaluated at three U.S. sites using the ADVIA Centaur Rubella M assay and a commercially available rubella IgM EIA. Prenatal, random hospital, and clinical specimens were obtained from the mid-Atlantic and Midwest regions of the United States as well as Canada and Germany. Of the 1054 specimens tested, 13 were equivocal by the ADVIA Centaur Rubella M assay. Discordant results were found on 18 specimens. Further testing was done on the discordant samples using other commercially available tests for rubella IgM. Relative Sensitivity Using the alternative method, 112/1054 tested positive for rubella IgM antibody. Of the specimens that tested positive, 1 was equivocal, 101 were positive, and 10 were negative using the ADVIA Centaur Rubella M assay. The relative sensitivity was 91.0%.

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ADVIA Centaur and ADVIA Centaur XP Systems

Relative Specificity Using the alternative method, 932/1054 tested negative for rubella IgM antibody. Of the specimens that tested negative, 11 were equivocal, 913 were negative, and 8 were positive using the ADVIA Centaur Rubella M assay. The relative specificity was 99.1%.
NOTE: Samples giving equivocal results were not included in the calculation of relative sensitivity, relative specificity, and relative agreement.

Please be advised that relative refers to the comparison of this assays results to that of a similar assay. There was not an attempt made to correlate the assays results with disease presence or absence. No judgment can be made on the comparison assays accuracy to predict disease.
Relative Sensitivity, Specificity, and Agreement Before Resolution of Discordant Samples Relative Relative Site N Sensitivity (%) Specificity (%) 1 300 92.3 (48/52) 99.6 (242/243) 2 377 85.3 (29/34) 99.8 (335/336) 3 377 96.0 (24/25) 98.3 (336/342) Total 1054 91.0 (101/111) 99.1 (913/921) Rubella IgM EIA Equivocal Negative 2 8 1 11 7 913 10 932 Relative Agreement (%) 98.3 (290/295) 98.4 (364/370) 98.1 (360/367) 98.3 (1014/1032)

ADVIA Centaur Rubella M

Positive Equivocal Negative Total

Positive 101 1 10 112

Total 111 13 930 1054

Relative sensitivity = 90.99% (101/111) 95% Confidence Limits 84.0695.59 Relative specificity = 99.13% (913/921) 95% Confidence Limits 98.3099.62 Relative agreement = 98.26% (1014/1032) 95% Confidence Limits 97.2698.96

Consensus Testing
Further analysis of the 18 specimens with discordant results was performed using an additional commercially available EIA for rubella IgM. Of the 10 samples that were negative by ADVIA Centaur and positive by EIA, 1 was equivocal, 3 were positive, and 6 were negative by consensus. Of the 8 that were positive by ADVIA Centaur and negative by EIA, 2 were positive and 6 were negative by consensus. Two of the 6 negative consensus specimens were positive by clinical symptoms and other methodology.

Precision
Reproducibility of the ADVIA Centaur Rubella M assay was determined as described in Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) protocol EP5-A2.10 A 16-member panel of serum and plasma was assayed 2 times in 2 separate daily runs, over a period of 20 days (n = 80). The following results were obtained using 1 reagent lot and a stored calibration curve:
Panel Member Sample Type Negative Control Positive Control 1 Serum 2 EDTA 3 Heparin 4 Sodium citrate N 80 80 80 80 80 80 Mean Concentration (Index Value) 0.18 1.16 0.21 0.19 0.19 0.18 Within-run SD % CV 0.04 NA* 0.04 3.4 0.04 NA 0.04 NA 0.04 NA 0.04 NA SD 0.07 0.06 0.06 0.07 0.07 0.08 Total % CV NA 5.5 NA NA NA NA

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ADVIA Centaur and ADVIA Centaur XP Systems Panel Member 5 6 7 8 9 10 11 12 13 14 15 16 * Mean Concentration (Index Value) 1.04 1.07 1.04 1.10 1.13 1.17 1.16 1.21 2.21 2.23 2.27 2.37 Within-run SD % CV 0.04 4.3 0.05 4.9 0.04 4.2 0.03 2.9 0.04 3.7 0.04 3.2 0.04 3.7 0.04 3.3 0.07 3.4 0.08 3.5 0.08 3.4 0.06 2.7

Rub M
SD 0.07 0.07 0.06 0.06 0.06 0.06 0.07 0.06 0.11 0.11 0.13 0.12 Total % CV 6.3 6.2 6.2 5.5 5.5 5.1 5.8 4.9 5.1 5.0 5.5 5.2

Sample Type Serum EDTA Heparin Sodium citrate Serum EDTA Heparin Sodium citrate Serum EDTA Heparin Sodium citrate

N 80 80 80 80 80 80 80 80 80 80 80 80

NA = Not Applicable. Includes within-run and run-to-run.

System reproducibility was determined by testing a 4-member panel with 3 reagent lots including 5 instruments and 3 sites over multiple days. The panel was assayed 3 times in each of 55 runs. The following results were obtained:
Panel Member Negative Control Positive Control 1 2 3 4 * N 171 171 170 171 171 168 Mean Concentration (Index Value) 0.31 1.54 0.33 1.47 1.92 2.65 SD 0.06 0.06 0.06 0.09 0.08 0.23 Within-run % CV NA* 5.22 NA 6.00 3.98 4.21 SD 0.07 0.11 0.07 0.11 0.09 0.16 Total % CV NA 7.58 NA 7.58 5.60 6.20

NA = Not Applicable. Includes within-run and run-to-run.

The reproducibility was also calculated for each individual site with each panel member. The following table summarizes the precision of three sites:
Rubella IgM Precision Summary by Site Panel Member Negative Negative Negative Positive Positive Positive 1 1 1 2 2 2 3 3 3 Site Code 1 2 3 1 2 3 1 2 3 1 2 3 1 2 3 N 141 15 15 141 15 15 140 15 15 141 15 15 141 15 15 Mean Concentration (Index Value) 0.30 0.45 0.33 1.54 1.59 1.51 0.31 0.50 0.36 1.44 1.66 1.57 1.90 2.07 1.95 Within-run SD % CV 0.06 NA* 0.07 NA 0.04 NA 0.06 4.2 0.08 5.2 0.05 3.1 0.06 NA 0.09 NA 0.02 NA 0.09 6.5 0.07 4.4 0.04 2.8 0.08 4.1 0.07 3.3 0.07 3.4 SD 0.07 0.08 0.05 0.09 0.09 0.06 0.07 0.11 0.02 0.12 0.09 0.08 0.12 0.09 0.13 Total % CV NA NA NA 5.8 5.5 3.9 NA NA NA 8.1 5.6 5.1 6.3 4.4 6.4

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Panel Member 4 4 4 * Site Code 1 2 3 N 141 12 15

ADVIA Centaur and ADVIA Centaur XP Systems Mean Concentration (Index Value) 2.60 2.93 2.87 Within-run SD % CV 0.11 4.4 0.10 3.4 0.09 3.2 Total % CV 6.6 3.4 4.3

SD 0.17 0.10 0.12

NA = Not Applicable. Includes within-run and run-to-run.

Evaluation of Potential Interfering Disease States

To further evaluate the specificity of the ADVIA Centaur Rubella M assay, 107 specimens from individuals with the various disease states were tested. The rubella IgM status of the specimens was confirmed using an alternate method. The results are shown in the following table:
Disease State Cytomegalovirus Epstein-Barr virus Herpes simplex virus Influenza vacinees Measles virus Parvovirus B19 Syphilis Varicella zoster virus Multiple myeloma Rheumatoid factor ANA Rubella IgM Status by Alternate Method Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive Negative Positive ADVIA Centaur Rubella M Assay Result < 1.00 Index Value 1.00 Index Value 9 0 0 1 9 0 0 0 10 0 0 0 10 0 0 0 4 0 0 6 10 0 0 0 10 0 0 0 8 0 0 0 10 0 0 0 10 0 0 0 10 0 0 0

Standardization
The ADVIA Centaur Rubella M assay standardization is based upon the relative clinical agreement with commercially available Rubella M assays (see Performance Characteristics). Assigned values for calibrations and controls are traceable to this standardization.

Technical Assistance
For customer support, contact your local technical support provider or distributor. www.siemens.com/diagnostics

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References
1. Armstrong AS, Safford JW, Holbert DN, Mushahra IK. Congenital diseases of microbiological origin. In: The Immunoassay Handbook: Applications. Edited by David Wood. New York: Stockton Press, 1994:499501. 2. Thomas HIJ, Morgan-Capner P, Roberts A, Hesketh L. Persistent rubella-specific IgM reactivity in the absence of recent primary rubella and rubella reinfection. Journal of Medical Virology. 1992;36:188-192. 3. Thomas HIJ, Barrett A, Hesketh LM, Wynne A, Morgan-Capner, P. Simultaneous IgM reactivity by EIA against more than one virus in measles, parvovirus B19 and rubella infection. Journal of Clinical Virology. 1999;14:107-118. 4. Cordoba P, Grutadauria S, Cuffini C, et al. Different affinity of monoclonal antibodies for conserved neutralizing epitopes on two strains of rubella virus. Viral Immunity. 1997;2:10310. 5. Katow S, Minahara H, Fukushima, Yamaguchi Y. Molecular epidemiology of rubella by nucleotide sequences of the rubella virus E1 gene in three east Asian countries. J Infect Dis. 1997;176:60216. 6. Centers for Disease Control. Update: Universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus and other bloodborne pathogens in healthcare settings. MMWR 1988;37:377-82, 387-8. 7. Clinical and Laboratory Standards Institute (formerly NCCLS). Protection of Laboratory Workers From Occupationally Acquired Infections; Approved Guideline - Third Edition. Wayne, PA: Clinical and Laboratory Standards Institute; 2005. NCCLS Document M29-A3. 8. Federal Occupational Safety and Health Administration, Bloodborne Pathogens Standard, 29 CFR 1910.1030. 9. Clinical and Laboratory Standards Institute (formerly NCCLS). How to Define and Determine Reference Intervals in the Clinical Laboratory; Approved Guideline - Second Edition. Wayne, PA: Clinical and Laboratory Standards Institute; 2000. NCCLS Document C28-A2. 10. Clinical and Laboratory Standards Institute (formerly NCCLS). Evaluation of Precision Performance of Quantitative Measurement Methods; Approved Guideline - Second Edition. Wayne, PA: Clinical and Laboratory Standards Institute; 2004. NCCLS Document EP5-A2.

ADVIA Centaur, ReadyPack, and ACS:180 are trademarks of Siemens Healthcare Diagnostics. 2010 Siemens Healthcare Diagnostics. All rights reserved. US Pats 5,609,822; 5,656,426; 5,788,928

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Rub M Understanding the Symbols

ADVIA Centaur and ADVIA Centaur XP Systems

The following symbols may appear on the product labeling:

Symbol Definition In vitro diagnostic medical device Manufacturer Symbol Definition Catalog number Authorized Representative in the European Community CE Mark with identification number of notified body

CE Mark

Consult instructions for use

Caution! Potential Biohazard

Do not freeze (> 0C)

Temperature limitation (28C)

Lower limit of temperature ( 2C)

Upper limit of temperature ( -10C)

Keep away from sunlight

Use by Shake the reagent pack vigorously. Refer to Loading Reagents in the assay-specific ADVIA Centaur product instructions for detailed information.

Store upright

Batch code

Contains sufficient for (n) tests

2010-01 Date format (year-month)

Green dot

Printed with soy ink

Recycle

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