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Antimicrob Steward Healthc Epidemiol . Respiratory surveillance through point of care molecular testing and its impacts on nursing home RSV, influen

tetano

Editor, Senior Moderator
Antimicrob Steward Healthc Epidemiol


. 2026 May 28;6(1):e155.
doi: 10.1017/ash.2026.10409. eCollection 2026.
Respiratory surveillance through point of care molecular testing and its impacts on nursing home RSV, influenza, and SARS-CoV-2 awareness and reporting behavior: a pilot study

H Edward Davidson[SUP] 1 [/SUP], Lisa F Han[SUP] 1 [/SUP], Kevin W McConeghy[SUP] 2 3 [/SUP], Ivis Perez[SUP] 1 [/SUP], Elizabeth A Sillman[SUP] 1 [/SUP], Clare Nugent[SUP] 4 [/SUP], Tiffany Wallace[SUP] 4 [/SUP], Laurel Holland[SUP] 4 [/SUP], Evan Dickerson[SUP] 4 [/SUP], David H Canaday[SUP] 5 6 [/SUP], Stefan Gravenstein[SUP] #[/SUP][SUP] 3 7 [/SUP], Yasin Abul[SUP] #[/SUP][SUP] 7 [/SUP]


Affiliations
Abstract

Objectives: To evaluate feasibility of establishing syndromic respiratory virus surveillance in a network of U.S. nursing homes, using CLIA-waived point-of-care (POC) molecular PCR testing, with centrally delivered results.
Design: Single-arm feasibility pilot study.
Setting and participants: Twenty-three nursing homes (NHs) in six U.S. states, representing approximately 2,500 residents.
Methods: A CLIA-waived POC molecular PCR testing device was implemented for on-site testing of respiratory syncytial virus (RSV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and influenza A and B from collected nasal swabs. Symptom data was entered at the time of testing. Test results were transmitted to a centralized, web-based dashboard providing near real-time surveillance from November 2023 to January 2025. Surveys of NH staff assessed device usability, workflow integration, impact on testing procedures, and infection and outbreak awareness.
Results: The established syndromic respiratory virus surveillance network conducted 1,745 point-of-care tests between November 2023 and January 2025, identifying 360 infections, including 160 COVID-19, 115 influenza A and B, and 81 RSV infections. Symptom data was captured for 99.5% of tests. Implementation was associated with high data completeness and integration into facility testing workflows. Staff reported an impact on testing protocols, infection awareness, and time to diagnosis.
Conclusions: Implementation of a CLIA-waived POC molecular testing device with centralized reporting was feasible across a geographically diverse NH network. The system achieved high data capture, identified substantial viral activity, and demonstrated value for clinical management using real-time diagnostic results. This approach can be adapted for local, regional, or national real-time reporting or future pragmatic interventional studies.


 
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