E Trabattoni1, V Le2, B Pilmis3, G Pean de Ponfilly2, C Caisso1, C Couzigou4, B Vidal4, A Mizrahi2, O Ganansia1, A Le Monnier2, B Lina5, J C Nguyen Van6. 1. Service des Urgences, Groupe Hospitalier Paris Saint-Joseph, Paris, France. 2. Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France. 3. Equipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France. 4. Equipe Mobile de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Equipe Opérationnelle d'Hygiène, Groupe Hospitalier Paris Saint-Joseph, Paris, France. 5. Laboratoire de Virologie Centre National de Référence des Virus Influenzae, Hôpital de la Croix Rousse, Lyon, France. 6. Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, Paris, France. Electronic address: jcnguyen@hpsj.fr.
Abstract
STUDY OBJECTIVE: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. METHODS: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N=301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic. Laboratory-based testing (standard of care) was used to obtain a diagnosis in February 2016 (pre-POCT cohort) and positive results were confirmed using polymerase chain reaction. The primary endpoint was patient time in the ED. RESULTS: A total of 169 and 132 patients participated in the pre-POCT phase and POCT phase respectively. A significantly higher proportion of patients received a positive diagnosis in the POCT cohort compared with the pre-POCT cohort (31% versus 5.3%, P<0.01). Mean time spent in the ED and hospitalization rate were significantly lower in the POCT cohort (6.06h versus 4.15h, P=0.03, and 44.4% versus 9.7%, P=0.02, respectively). Despite similar rates in the prescription of antibiotics and antiviral therapies, the proportion of patients who were referred for additional tests was significantly lower in the POCT cohort (78.1% versus 62.1%, P=0.003, and 80.5% versus 63.6%, P=0.01, respectively). CONCLUSIONS: The Alere i Influenza A & B POCT reduced the length of stay in ED, the hospitalization rates, and the number of additional diagnostic tests compared with standard of care testing.
STUDY OBJECTIVE: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. METHODS: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N=301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic. Laboratory-based testing (standard of care) was used to obtain a diagnosis in February 2016 (pre-POCT cohort) and positive results were confirmed using polymerase chain reaction. The primary endpoint was patient time in the ED. RESULTS: A total of 169 and 132 patients participated in the pre-POCT phase and POCT phase respectively. A significantly higher proportion of patients received a positive diagnosis in the POCT cohort compared with the pre-POCT cohort (31% versus 5.3%, P<0.01). Mean time spent in the ED and hospitalization rate were significantly lower in the POCT cohort (6.06h versus 4.15h, P=0.03, and 44.4% versus 9.7%, P=0.02, respectively). Despite similar rates in the prescription of antibiotics and antiviral therapies, the proportion of patients who were referred for additional tests was significantly lower in the POCT cohort (78.1% versus 62.1%, P=0.003, and 80.5% versus 63.6%, P=0.01, respectively). CONCLUSIONS: The Alere i Influenza A & B POCT reduced the length of stay in ED, the hospitalization rates, and the number of additional diagnostic tests compared with standard of care testing.
Authors: E Pawelka; Mario Karolyi; S Daller; C Kaczmarek; H Laferl; I Niculescu; B Schrader; C Stütz; A Zoufaly; C Wenisch Journal: Infection Date: 2019-06-15 Impact factor: 3.553
Authors: Mario Karolyi; Erich Pawelka; Simon Daller; Caroline Kaczmarek; Hermann Laferl; Iulia Niculescu; Birte Schrader; Christian Stütz; Alexander Zoufaly; Christoph Wenisch Journal: Wien Klin Wochenschr Date: 2019-06-18 Impact factor: 1.704