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Clinical impact of the rapid molecular detection of RSV and influenza A and B viruses in the emergency department.
Yin, Nicolas; Van Nuffelen, Marc; Bartiaux, Magali; Préseau, Thierry; Roggen, Inge; Delaunoy, Sabrina; Mahadeb, Bhavna; Dahma, Hafid; Busson, Laurent; Vandenberg, Olivier; Hallin, Marie.
  • Yin N; Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Van Nuffelen M; Emergency Department, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Bartiaux M; Emergency Department, Saint-Pierre University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Préseau T; Emergency Department, Brugmann University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Roggen I; Emergency Department, Queen Fabiola Pediatric University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Delaunoy S; Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Mahadeb B; Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Dahma H; Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Busson L; Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Vandenberg O; Clinical Research and Innovation Unit, Laboratoire Hospitalier Universitaire de Bruxelles-Universitair Laboratorium Brussel (LHUB-ULB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Hallin M; Centre for Environmental Health and Occupational Health, School of Public Health, Université Libre de Bruxelles (ULB), Brussels, Belgium.
PLoS One ; 17(9): e0274222, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2021957
ABSTRACT

INTRODUCTION:

Using respiratory virus rapid diagnostic tests in the emergency department could allow better and faster clinical management. Point-of-care PCR instruments now provide results in less than 30 minutes. The objective of this study was to assess the impact of the use of a rapid molecular diagnostic test, the cobas® Influenza A/B & RSV Assay, during the clinical management of emergency department patients.

METHODS:

Patients (adults and children) requiring admission or suffering from an underlying condition at risk of respiratory complications were prospectively recruited in the emergency department of four hospitals in the Brussels region. Physicians' intentions regarding admission, isolation, antibiotic, and antiviral use were collected before and after performing the rapid molecular test. Additionally, a comparison of the analytical performance of this test against antigen rapid tests and viral culture was performed as well as a time-to-result evaluation.

RESULTS:

Among the 293 patients recruited, 90 had a positive PCR, whereas 44 had a positive antigen test. PCR yielded a sensitivity of 100% for all targets. Antigen tests yielded sensitivities ranging from 66.7% for influenza B to 83.3% for respiratory syncytial virus (RSV). The use of PCR allowed a decrease in the overall need for isolation and treatment by limiting the isolation of negative patients and antibiotic use for positive patients. Meanwhile, antiviral treatments better targeted patients with a positive influenza PCR.

CONCLUSION:

The use of a rapid influenza and RSV molecular test improves the clinical management of patients admitted to the emergency department by providing a fast and reliable result. Their additional cost compared to antigen tests should be balanced with the benefit of their analytical performance, leading to efficient reductions in the need for isolation and antibiotic use.
Assuntos

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Vírus da Influenza A / Vírus Sincicial Respiratório Humano / Infecções por Vírus Respiratório Sincicial / Herpesvirus Cercopitecino 1 / Influenza Humana Tipo de estudo: Estudo diagnóstico / Estudo experimental / Estudo prognóstico Limite: Adulto / Criança / Humanos Idioma: Inglês Revista: PLoS One Assunto da revista: Ciência / Medicina Ano de publicação: 2022 Tipo de documento: Artigo País de afiliação: Journal.pone.0274222

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Vírus da Influenza A / Vírus Sincicial Respiratório Humano / Infecções por Vírus Respiratório Sincicial / Herpesvirus Cercopitecino 1 / Influenza Humana Tipo de estudo: Estudo diagnóstico / Estudo experimental / Estudo prognóstico Limite: Adulto / Criança / Humanos Idioma: Inglês Revista: PLoS One Assunto da revista: Ciência / Medicina Ano de publicação: 2022 Tipo de documento: Artigo País de afiliação: Journal.pone.0274222