Clinical Studies
Impact of a multiplex PCR point-of-care test for influenza A/B and respiratory syncytial virus on an acute pediatric hospital ward

https://doi.org/10.1016/j.diagmicrobio.2018.03.013Get rights and content

Abstract

Patients with respiratory infections are often managed presumptively until confirmation of infection status. We assessed the impact of introducing the Enigma® MiniLab™ FluAB-RSV point-of-care test (POCT) on patients admitted with a suspected respiratory virus driven illness in an acute pediatric ward. This utilized a before and after design (respiratory viral seasons 2013/14 versus 2014/15). Following POCT implementation, oseltamivir prescribing increased in patients with influenza (OR = 12.7, P = 0.05, 95% CI [1.0, 153.8]). A reduction in the average reimbursement charges without a change in the length of stay was observed. Modeling suggested that laboratory test cost savings could be achieved if the POCT cost £30 and was used for screening, followed by the respiratory viral panel for RSV and influenza negative patients. A rapid POCT for influenza A/B and RSV infections in pediatric inpatients may improve oseltamivir prescribing, strengthen antimicrobial stewardship, reduce reimbursement charges and decrease laboratory costs.

Keywords

Respiratory syncytial virus
Influenza virus A
Influenza virus B
Point-of-care technology
Rapid diagnostic tests

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Acknowledgments: This study was funded by Enigma Diagnostics, and supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. The study, data analysis and discussion were independently carried out by the study team, and all analysis and discussion are the authors’ own.

We would like to thank all of the staff at St Thomas’ Hospital who collected the data for this study, in particular the staff on Mountain Ward (acute pediatric inpatient ward). Certain people provided extra help and advice: Charlotte Walker, Victoria Felton, Lorraine Colthurst, James Ross, David Taylor, Phillip Li, Jane Tozer, John Roberts, Jamie Crocker, Paul Wade, Nuria Martinez-Alier, and Karen Stein. Thanks to Daniel Gibbons for useful comments.

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