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Point of care testing of Influenza A/B and RSV in an adult respiratory assessment unit is associated with improvement in isolation practices and reduction in hospital length of stay.
Journal of Medical Microbiology ( IF 2.4 ) Pub Date : 2020-04-06 , DOI: 10.1099/jmm.0.001187
Louise Berry 1 , Louise Lansbury 2 , Lydia Gale 1 , Ann Marie Carroll 1 , Wei Shen Lim 3
Affiliation  

Introduction. Every winter seasonal influenza and other viral respiratory infections increase pressure on the health services and are associated with nosocomial infection and morbidity.Aim. To compare provision of point-of-care (POC) testing with laboratory-based testing for influenza and RSV detection on an adult respiratory assessment unit to assess the impact on isolation practices and length of stay (LOS).Methodology. Prospective interrupted 'on-off' study in adults admitted to the respiratory unit between December 2018 and April 2019 with a suspected respiratory tract infection. Nasopharyngeal samples were tested using either the GeneXpert rapid POC test for influenza and RSV (on-period), or were sent to the laboratory for multiplex PCR testing against a panel of 12 respiratory viruses (off-period). Outcome measures were time to patient isolation for infection control, LOS and turnaround time from admission to test results.Results. Of 1145 patients evaluated, 755 were tested with POC and 390 with laboratory multiplex; a respiratory virus was identified in 164 (21.7 %) and 138 (35.4 %) patients respectively. A positive POC test was associated with a shorter time to isolation (mean difference 16.9 h, P<0.001), shorter LOS (mean difference 15.5 h, P=0.05,) and shorter turnaround time (mean difference 28.3 h, P<0.001), compared to laboratory testing.Conclusion. Use of GeneXpert POC testing for Flu/RSV is associated with rapid reporting of results with significant improvements in isolation practices and reductions in LOS.

中文翻译:


在成人呼吸评估室中对 A/B 型流感和 RSV 进行护理点检测与隔离措施的改进和住院时间的缩短有关。



介绍。每年冬季,季节性流感和其他病毒性呼吸道感染都会增加卫生服务的压力,并与院内感染和发病率相关。目的。比较成人呼吸评估装置上提供的护理点 (POC) 检测与基于实验室的流感和 RSV 检测检测,以评估对隔离实践和住院时间 (LOS) 的影响。方法。对 2018 年 12 月至 2019 年 4 月期间因疑似呼吸道感染而入住呼吸科的成人进行前瞻性中断“开关”研究。鼻咽样本使用 GeneXpert 流感和 RSV 快速 POC 检测(正常期)进行检测,或者送往实验室针对 12 种呼吸道病毒进行多重 PCR 检测(非期)。结果指标包括患者隔离以控制感染的时间、LOS 以及从入院到检测结果的周转时间。结果。在接受评估的 1145 名患者中,755 名接受了 POC 测试,390 名接受了实验室多重测试;分别在 164 名 (21.7%) 和 138 名 (35.4%) 患者中发现呼吸道病毒。 POC 测试阳性与更短的隔离时间(平均差 16.9 小时,P<0.001)、更短的 LOS(平均差 15.5 小时,P=0.05)和更短的周转时间(平均差 28.3 小时,P<0.001)相关。 ,与实验室测试相比。结论。使用 GeneXpert POC 检测流感/RSV 可以快速报告结果,显着改进隔离实践并减少 LOS。
更新日期:2020-04-06
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