Take-home kits to detect respiratory viruses among healthcare personnel: Lessons learned from a cluster randomized clinical trial.


Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
07 2021
Historique:
received: 24 01 2021
revised: 02 02 2021
accepted: 04 02 2021
pubmed: 14 2 2021
medline: 13 8 2021
entrez: 13 2 2021
Statut: ppublish

Résumé

Health care personnel (HCP) working in outpatient settings routinely interact with patients with acute respiratory illnesses. Absenteeism following symptom development and lack of staff trained to obtain samples limit efforts to identify pathogens among infected HCP. The Respiratory Protection Effectiveness Clinical Trial assessed respiratory infection incidence among HCP between 2011 and 2015. Research assistants obtained anterior nasal and oropharyngeal swabs from HCP in the workplace following development of respiratory illness symptoms and randomly while asymptomatic. Participants received take-home kits to self-collect swabs when absent from work. Samples mailed to a central laboratory were tested for respiratory viruses by reverse transcription polymerase chain reaction. Among 2,862 participants, 3,467 swabs were obtained from symptomatic participants. Among symptomatic HCP, respiratory virus was detected in 904 of 3,467 (26.1%) samples. Self-collected samples by symptomatic HCP at home had higher rates of viral detection (40.3%) compared to 24% obtained by trained research assistants in the workplace (P < .001). In this randomized clinical trial, take-home kits were an easily implemented, effective method to self-collect samples by HCP. Other studies have previously shown relative equivalence of self-collected samples to those obtained by trained healthcare workers. Take-home kit self-collection could diminish workforce exposures and decrease the demand for personnel protective equipment worn to protect workers who collect respiratory samples.

Sections du résumé

BACKGROUND
Health care personnel (HCP) working in outpatient settings routinely interact with patients with acute respiratory illnesses. Absenteeism following symptom development and lack of staff trained to obtain samples limit efforts to identify pathogens among infected HCP.
METHODS
The Respiratory Protection Effectiveness Clinical Trial assessed respiratory infection incidence among HCP between 2011 and 2015. Research assistants obtained anterior nasal and oropharyngeal swabs from HCP in the workplace following development of respiratory illness symptoms and randomly while asymptomatic. Participants received take-home kits to self-collect swabs when absent from work. Samples mailed to a central laboratory were tested for respiratory viruses by reverse transcription polymerase chain reaction.
RESULTS
Among 2,862 participants, 3,467 swabs were obtained from symptomatic participants. Among symptomatic HCP, respiratory virus was detected in 904 of 3,467 (26.1%) samples. Self-collected samples by symptomatic HCP at home had higher rates of viral detection (40.3%) compared to 24% obtained by trained research assistants in the workplace (P < .001).
CONCLUSIONS
In this randomized clinical trial, take-home kits were an easily implemented, effective method to self-collect samples by HCP. Other studies have previously shown relative equivalence of self-collected samples to those obtained by trained healthcare workers. Take-home kit self-collection could diminish workforce exposures and decrease the demand for personnel protective equipment worn to protect workers who collect respiratory samples.

Identifiants

pubmed: 33581146
pii: S0196-6553(21)00056-0
doi: 10.1016/j.ajic.2021.02.001
pmc: PMC7874979
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT01249625']

Types de publication

Journal Article Randomized Controlled Trial Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

893-899

Informations de copyright

Copyright © 2021 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Auteurs

Jenna Los (J)

Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: jlos1@jhmi.edu.

Charlotte A Gaydos (CA)

Johns Hopkins University School of Medicine, Baltimore, MD.

Cynthia L Gibert (CL)

Washington DC Veterans Affairs Medical Center, Washington, DC.

Geoffrey J Gorse (GJ)

VA St. Louis Health Care System and Saint Louis University School of Medicine St. Louis, MO.

Jacquelyn Lykken (J)

University of Texas Southwestern Medical Center, Dallas, TX.

Ann-Christine Nyquist (AC)

Children's Hospital Colorado, Aurora, CO; University of Colorado School of Medicine, Aurora, CO.

Connie S Price (CS)

University of Colorado School of Medicine, Aurora, CO; Denver Health and Hospital, Denver, CO.

Lewis J Radonovich (LJ)

Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, GA.

Susan Rattigan (S)

University of Florida, Gainesville, FL.

Nicholas Reich (N)

University of Massachusetts, Amherst, MA.

Maria Rodriguez-Barradas (M)

Michael E. DeBakey VA Medical Center, Houston, TX.

Michael Simberkoff (M)

New York Harbor Healthcare System, New York, NY.

Mary Bessesen (M)

University of Colorado School of Medicine, Aurora, CO; VA-Eastern Colorado Healthcare System, Denver, CO.

Alexandria Brown (A)

University of Massachusetts, Amherst, MA.

Derek A T Cummings (DAT)

University of Florida, Gainesville, FL.

Trish M Perl (TM)

Johns Hopkins University School of Medicine, Baltimore, MD; University of Texas Southwestern Medical Center, Dallas, TX.

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Classifications MeSH