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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 po

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Editor, Senior Moderator
Antimicrob Resist Infect Control. 2019 Jul 16;8:120. doi: 10.1186/s13756-019-0575-6. eCollection 2019.
[h=1]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.[/h] Garvey MI[SUP]1,[/SUP][SUP]2[/SUP], Wilkinson MAC[SUP]1[/SUP], Bradley CW[SUP]3[/SUP], Biggs M[SUP]1[/SUP], Reddy-Kolanu V[SUP]1[/SUP], Osman H[SUP]1[/SUP], Carmalt S[SUP]1[/SUP], Holden E[SUP]1[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Background:[/h] 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.
[h=4]Methods:[/h] 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.
[h=4]Results:[/h] 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%).
[h=4]Discussion:[/h] 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.
[h=4]Conclusions:[/h] Routine use of POCTs for viruses should be introduced into diagnostic pathways for acute respiratory illness, especially at the front door of hospitals.


[h=4]KEYWORDS:[/h] Acute medical unit; Emergency department; Influenza; PCR; Point of care testing

PMID: 31346461 PMCID: PMC6636012 DOI: 10.1186/s13756-019-0575-6
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