tetano
Editor, Senior Moderator
Pediatr Infect Dis J. 2019 Jun;38(6):559-563. doi: 10.1097/INF.0000000000002224.
[h=1]Impact of Rapid On-demand Molecular Diagnosis of Pediatric Seasonal Influenza on Laboratory Workflow and Testing Costs: A Retrospective Study.[/h] Brotons P[SUP]1,[/SUP][SUP]2[/SUP], Nogueras MM[SUP]1,[/SUP][SUP]2[/SUP], Valls A[SUP]3[/SUP], Larrauri A[SUP]2,[/SUP][SUP]4[/SUP], Dominguez A[SUP]2,[/SUP][SUP]5[/SUP], Launes C[SUP]1,[/SUP][SUP]2[/SUP], Luaces-Cubells C[SUP]6[/SUP], Mu?oz-Almagro C[SUP]1,[/SUP][SUP]2,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Seasonal influenza imposes a considerable burden worldwide. We aimed to evaluate impact of rapid pediatric seasonal influenza diagnosis on laboratory workflow and cost using a rapid antigen detection-based test combined with either a reverse transcriptase polymerase chain reaction (RT-PCR) or the Alere i Influenza A and B (Alere i) assay for confirmation of negative results as well as single Alere i testing on nasopharyngeal aspirates. A secondary objective was assessing performance of Alere i against RT-PCR.
[h=4]METHODS:[/h] Effects of implementing the 3 diagnostic algorithms were assessed in the Emergency Department of Hospital Sant Joan de D?u (Barcelona, Spain) across the 2014-2015, 2015-2016 and 2016-2017 influenza seasons. Alere i performance against RT-PCR was determined during the 2015-2016 epidemic period.
[h=4]RESULTS:[/h] Median time to result decreased when using Alere i as a confirmatory test of previous antigen detection and RT-PCR results or alone (9.7vs. 3.5/2.0 and 0.7 hours, P < 0.001) along with mean testing costs (&OV0556;87.3 vs. &OV0556;38.2 and &OV0556;25.0, P < 0.001). Results available before patient discharge from the emergency department increased from 42.7% for sequential testing by antigen detection and RT-PCR to 80.0% when Alere i was utilized as a stand-alone test. Alere i sensitivity and specificity values were 96.6% (95% confidence interval: 82.8%-99.4%) and 94.4% (95% confidence interval: 86.6%-97.8%), respectively.
[h=4]CONCLUSIONS:[/h] Rapid Alere i testing facilitated efficient laboratory workflow near the patient during influenza epidemics while contributing cost savings when compared with serial testing by antigen and RT-PCR assays.
PMID: 31117115 DOI: 10.1097/INF.0000000000002224
[h=1]Impact of Rapid On-demand Molecular Diagnosis of Pediatric Seasonal Influenza on Laboratory Workflow and Testing Costs: A Retrospective Study.[/h] Brotons P[SUP]1,[/SUP][SUP]2[/SUP], Nogueras MM[SUP]1,[/SUP][SUP]2[/SUP], Valls A[SUP]3[/SUP], Larrauri A[SUP]2,[/SUP][SUP]4[/SUP], Dominguez A[SUP]2,[/SUP][SUP]5[/SUP], Launes C[SUP]1,[/SUP][SUP]2[/SUP], Luaces-Cubells C[SUP]6[/SUP], Mu?oz-Almagro C[SUP]1,[/SUP][SUP]2,[/SUP][SUP]7[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Seasonal influenza imposes a considerable burden worldwide. We aimed to evaluate impact of rapid pediatric seasonal influenza diagnosis on laboratory workflow and cost using a rapid antigen detection-based test combined with either a reverse transcriptase polymerase chain reaction (RT-PCR) or the Alere i Influenza A and B (Alere i) assay for confirmation of negative results as well as single Alere i testing on nasopharyngeal aspirates. A secondary objective was assessing performance of Alere i against RT-PCR.
[h=4]METHODS:[/h] Effects of implementing the 3 diagnostic algorithms were assessed in the Emergency Department of Hospital Sant Joan de D?u (Barcelona, Spain) across the 2014-2015, 2015-2016 and 2016-2017 influenza seasons. Alere i performance against RT-PCR was determined during the 2015-2016 epidemic period.
[h=4]RESULTS:[/h] Median time to result decreased when using Alere i as a confirmatory test of previous antigen detection and RT-PCR results or alone (9.7vs. 3.5/2.0 and 0.7 hours, P < 0.001) along with mean testing costs (&OV0556;87.3 vs. &OV0556;38.2 and &OV0556;25.0, P < 0.001). Results available before patient discharge from the emergency department increased from 42.7% for sequential testing by antigen detection and RT-PCR to 80.0% when Alere i was utilized as a stand-alone test. Alere i sensitivity and specificity values were 96.6% (95% confidence interval: 82.8%-99.4%) and 94.4% (95% confidence interval: 86.6%-97.8%), respectively.
[h=4]CONCLUSIONS:[/h] Rapid Alere i testing facilitated efficient laboratory workflow near the patient during influenza epidemics while contributing cost savings when compared with serial testing by antigen and RT-PCR assays.
PMID: 31117115 DOI: 10.1097/INF.0000000000002224