King's College, London and Guy's & St Thomas' NHS Foundation Trust, UK.
Optimity Matrix, London, UK.
J Infect. 2015 May;70(5):504-11. doi: 10.1016/j.jinf.2014.11.009. Epub 2014 Nov 29.
Recent advances in the laboratory detection of infectious diarrhoea allow more rapid and sensitive identification of infected patients. Several commercial multiplex molecular panels are now available and may have significant advantages over culture based techniques. Faster and more sensitive testing of hospitalised patients with suspected infectious gastroenteritis could result in significant efficiencies in the utilisation of isolation facilities, however few studies have examined this potential benefit. We studied the potential clinical and cost benefits of a commercially available molecular panel.
An eight-month parallel diagnostic study was conducted to measure potential economic benefits of testing hospitalised patients with the Luminex xTAG Gastrointestinal Pathogen Panel (GPP) compared with conventional laboratory testing (based on a combination of culture, microscopy and enzyme immunoassay). Laboratory testing costs and patient isolation costs were measured or estimated for 800 patients.
Although costing an additional £22,283, use of GPP could enable a reduction in isolation time from 2202 to 1447 days, a saving of £66,765, which more than offsets the additional laboratory testing costs.
Syndromic testing of patients against a broad panel of organisms using a multiplex molecular panel can both improve detection rates and allow better laboratory workflow practices. Removing patients testing negative using this panel could result in significant patient isolation savings.
最近在传染病实验室检测方面的进展使我们能够更快、更敏感地识别感染患者。目前有几种商业多重分子面板,它们可能比基于培养的技术具有显著优势。更快、更敏感地检测疑似感染性肠胃炎的住院患者,可能会极大地提高隔离设施的利用效率,但很少有研究探讨这种潜在的益处。我们研究了一种商业上可用的分子面板的潜在临床和成本效益。
进行了为期 8 个月的平行诊断研究,以衡量使用 Luminex xTAG 胃肠道病原体检测试剂盒(GPP)与常规实验室检测(基于培养、显微镜和酶免疫测定的组合)相比,对住院患者进行检测的潜在经济优势。对 800 名患者进行了实验室检测成本和患者隔离成本的测量或估算。
尽管使用 GPP 会额外增加 22283 英镑的成本,但它可以将隔离时间从 2202 天减少到 1447 天,节省 66765 英镑,这足以抵消额外的实验室检测成本。
使用多重分子面板对广泛的病原体进行综合征检测,可以提高检测率,并允许更好地进行实验室工作流程。使用该面板对检测结果为阴性的患者进行分流,可以节省大量的患者隔离成本。