tetano
Editor, Senior Moderator
Clin Microbiol Infect. 2018 Nov 28. pii: S1198-743X(18)30748-1. doi: 10.1016/j.cmi.2018.11.019. [Epub ahead of print]
[h=1]Impact of bedside diagnosis of influenza in the paediatric emergency ward.[/h] Cantais A[SUP]1[/SUP], Mory O[SUP]2[/SUP], Plat A[SUP]2[/SUP], Bourmaud A[SUP]3[/SUP], Giraud A[SUP]2[/SUP], Costille M[SUP]2[/SUP], Pozzetto B[SUP]4[/SUP], Pillet S[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] This prospective study performed in the paediatric emergency department of the University Hospital of Saint-Etienne aimed to measure the impact of the 24/7 bedside use of the Veritor? System (Becton Dickinson) on the reduction of supplementary investigations, hospital stay and antimicrobial use.
[h=4]METHODS:[/h] Influenzavirus A and B antigens were detected with a rapid influenza digital immunoassay (DIA) on nasopharyngeal aspirates (NPA) sampled from the children consulting at the paediatric emergency department between January and March 2016 for influenza-like illness. The same NPA was tested by immunofluorescence and/or molecular routine assays. Before performing the DIA, the clinician filled in a questionnaire listing the tests that he/she would have prescribed in the absence of the rapid testing. The prescription of complementary investigations, antimicrobial treatments and hospital stay were also compared to those of the 3 previous years.
[h=4]RESULTS:[/h] A total of 514 children with flu-like symptoms were included. The use of the DIA at bedside decreased the prescription of blood puncture by 47.9% (21.2% to 6.6%), of chest X-rays by 69.0% (33.3% to 10.3%), of lumbar puncture by 77.8% (7.0% to 1.6%), of urine culture by 79.2% (23.3% to 4.9%), of antibiotic treatments by 70.1% (16.9% to 5.1%) and of hospital stay by 25.0% (27.2% to 20.4%), resulting in a reduction of medical costs estimated to more than ?69,000 in a season.
[h=4]CONCLUSIONS:[/h] In addition to deliver a rapid aetiological diagnosis, this strategy save medical costs and favour antimicrobial stewardship strategy. However, further prospective studies are needed to confirm our findings.
Copyright ? 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PMID: 30502486 DOI: 10.1016/j.cmi.2018.11.019
[h=1]Impact of bedside diagnosis of influenza in the paediatric emergency ward.[/h] Cantais A[SUP]1[/SUP], Mory O[SUP]2[/SUP], Plat A[SUP]2[/SUP], Bourmaud A[SUP]3[/SUP], Giraud A[SUP]2[/SUP], Costille M[SUP]2[/SUP], Pozzetto B[SUP]4[/SUP], Pillet S[SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]OBJECTIVES:[/h] This prospective study performed in the paediatric emergency department of the University Hospital of Saint-Etienne aimed to measure the impact of the 24/7 bedside use of the Veritor? System (Becton Dickinson) on the reduction of supplementary investigations, hospital stay and antimicrobial use.
[h=4]METHODS:[/h] Influenzavirus A and B antigens were detected with a rapid influenza digital immunoassay (DIA) on nasopharyngeal aspirates (NPA) sampled from the children consulting at the paediatric emergency department between January and March 2016 for influenza-like illness. The same NPA was tested by immunofluorescence and/or molecular routine assays. Before performing the DIA, the clinician filled in a questionnaire listing the tests that he/she would have prescribed in the absence of the rapid testing. The prescription of complementary investigations, antimicrobial treatments and hospital stay were also compared to those of the 3 previous years.
[h=4]RESULTS:[/h] A total of 514 children with flu-like symptoms were included. The use of the DIA at bedside decreased the prescription of blood puncture by 47.9% (21.2% to 6.6%), of chest X-rays by 69.0% (33.3% to 10.3%), of lumbar puncture by 77.8% (7.0% to 1.6%), of urine culture by 79.2% (23.3% to 4.9%), of antibiotic treatments by 70.1% (16.9% to 5.1%) and of hospital stay by 25.0% (27.2% to 20.4%), resulting in a reduction of medical costs estimated to more than ?69,000 in a season.
[h=4]CONCLUSIONS:[/h] In addition to deliver a rapid aetiological diagnosis, this strategy save medical costs and favour antimicrobial stewardship strategy. However, further prospective studies are needed to confirm our findings.
Copyright ? 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
PMID: 30502486 DOI: 10.1016/j.cmi.2018.11.019