Impact of a PCR point of care test for influenza A/B on an acute medical unit in a large UK teaching hospital: Results of an observational, pre and post intervention study

Mark I. Garvey, Martyn A.C. Wilkinson, Craig W. Bradley, Martin Biggs, Vinay Reddy-Kolanu, Husam Osman, Sarah Carmalt, Elisabeth Holden

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9 Citations (Scopus)

Abstract

Background: Influenza viruses is a leading cause of acute respiratory infection, placing a significant burden on healthcare. To reduce hospital transmission, patients clinically suspected of having influenza are isolated and offered empirical antiviral treatment. Here we report the use of a point of care test (POCT) for influenza viruses in an acute medical unit (AMU) at Queen Elizabeth Hospital Birmingham for patients presenting with influenza-like illness. Methods: A PCR POCT was installed on AMU in Dec 17-Mar 18 (period 2) and used to test any patient with influenza-like illness. We conducted an evaluation against influenza virus's data collected between Dec 16-Mar 17 (period 1) where no POCT was used. Four outcomes were measured: Length of stay, oseltamivir utilisation, time to isolation and in-hospital cases of influenza viruses. Results: There were 51 confirmed influenza virus cases in period 1 vs 666 in period 2. During period 2, the length of stay of patients presenting with influenza-like illness (2.4 vs 7.9 days) and time to isolation from receipt of a positive result (0.09 vs 1.26 days) was significantly shorter. The time to initial receipt of antivirals for patients with influenza virus was significantly quicker in period 2 (0.59 vs 1.1 days) and the total number of influenza virus cases identified after 72 h of admission was significantly lower (9% vs 51%). Discussion: Following introduction of the POCT, there was an increase in appropriately targeted oseltamivir prescribing, shorter time to isolation, proportionally less post-72-h influenza virus cases and a reduction in length of stay of patients presenting with influenza-like illness. Conclusions: Routine use of POCTs for viruses should be introduced into diagnostic pathways for acute respiratory illness, especially at the front door of hospitals.

Original languageEnglish
Article number120
JournalAntimicrobial Resistance and Infection Control
Volume8
Issue number1
DOIs
Publication statusPublished - 16 Jul 2019
Externally publishedYes

Keywords

  • Acute medical unit
  • Emergency department
  • Influenza
  • PCR
  • Point of care testing

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