Clinical impact of the rapid molecular detection of RSV and influenza A and B viruses in the emergency department.
Adult
Anti-Bacterial Agents
/ therapeutic use
Antiviral Agents
Child
Emergency Service, Hospital
Herpesvirus 1, Cercopithecine
Humans
Influenza A virus
/ genetics
Influenza B virus
/ genetics
Influenza, Human
/ diagnosis
Respiratory Syncytial Virus Infections
/ diagnosis
Respiratory Syncytial Virus, Human
/ genetics
Sensitivity and Specificity
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
16
03
2022
accepted:
23
08
2022
entrez:
2
9
2022
pubmed:
3
9
2022
medline:
9
9
2022
Statut:
epublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 36054246
doi: 10.1371/journal.pone.0274222
pii: PONE-D-22-07593
pmc: PMC9439204
doi:
Substances chimiques
Anti-Bacterial Agents
0
Antiviral Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0274222Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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