Background

The feasibility of introducing three separate Cepheid GeneXpert® assays was assessed: Xpert SA Nasal Complete, Xpert C. difficile, and Xpert Norovirus for point-of-care testing (POCT) on a ward in a district general hospital.

Aim

To establish a seven-day/24 h POCT service for meticillin-resistant Staphylococcus aureus (MRSA), Clostridioides difficile, and norovirus operated solely by healthcare workers (HCWs).

Methods

The Cepheid GeneXpert assays performance characteristics were assessed by comparing the assays to traditional central laboratory methods in terms of clinical turnaround times, hands-on time, number of process steps, time to result and diagnostic accuracy. HCW feedback was collected to consider the potential added value of applying this technology to improve patient flow and clinical care.

Findings

In total 1170 tests were carried out over the 16-month study period. The assays significantly reduced hands-on time, process steps, and time to result for identification of all three micro-organisms. Overall agreement with central laboratory testing was >98% for all three assays. Staff members fed back that POCT had a positive impact in terms of clinical utility.

Conclusion

Xpert SA Nasal Complete for MRSA detection, Xpert C. difficile, and Xpert Norovirus can be used as POCT solely by HCWs in a ward setting. Each assay was used throughout a seven-day/24 h period with potential positive impact on bed management and patient care.

中文翻译：

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S.Dewar等。由医护人员进行的即时点检测，以检测耐甲氧西林的金黄色葡萄球菌，艰难梭菌和诺如病毒

背景

在地区综合性医院的病房中，评估了引入三种单独的CepheidGeneXpert®检测方法的可行性：Xpert SA鼻腔完全检测法，Xpert艰难梭菌和Xpert诺如病毒用于现场护理测试（POCT）。

目的

为耐甲氧西林的金黄色葡萄球菌（MRSA），艰难梭菌和诺如病毒建立由医务工作者（HCW）单独运营的7天/ 24小时POCT服务。

方法

通过在临床周转时间，动手时间，处理步骤数，结果时间和诊断准确性方面与传统的中央实验室方法进行比较，对Cepheid GeneXpert分析的性能特征进行了评估。收集了HCW反馈意见，以考虑应用该技术改善患者流量和临床护理的潜在附加价值。

发现

在16个月的研究期内，总共进行了1170项测试。该测定显着减少了动手时间，工艺步骤和时间，以鉴定所有三种微生物。对于所有三种测定，与中央实验室测试的总体一致性均> 98％。工作人员反馈说，POCT在临床实用性方面具有积极影响。

结论

用于MRSA检测的Xpert SA Nasal Complete，艰难梭菌和Xpert Norovirus只能由病房中的医护人员用作POCT。在整个7天/ 24小时内使用每种测定法，对床位管理和患者护理具有潜在的积极影响。