Vecino-Ortiz Andres I, Goldenberg Simon D, Douthwaite Sam T, Cheng Chih-Yuan, Glover Rebecca E, Mak Catherine, Adams Elisabeth J
Aquarius Population Health Limited, 58a Highgate High Street, London, N6 5HX, UK; Department of International Health, Johns Hopkins School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
Centre for Clinical Infection and Diagnostics Research, King's College, London and Guy's & St. Thomas' NHS Foundation Trust, London, UK SE1 7EH.
Diagn Microbiol Infect Dis. 2018 Aug;91(4):331-335. doi: 10.1016/j.diagmicrobio.2018.03.013. Epub 2018 Apr 4.
Patients with respiratory infections are often managed presumptively until confirmation of infection status. We assessed the impact of introducing the Enigma® MiniLab™ FluAB-RSV point-of-care test (POCT) on patients admitted with a suspected respiratory virus driven illness in an acute pediatric ward. This utilized a before and after design (respiratory viral seasons 2013/14 versus 2014/15). Following POCT implementation, oseltamivir prescribing increased in patients with influenza (OR = 12.7, P = 0.05, 95% CI [1.0, 153.8]). A reduction in the average reimbursement charges without a change in the length of stay was observed. Modeling suggested that laboratory test cost savings could be achieved if the POCT cost £30 and was used for screening, followed by the respiratory viral panel for RSV and influenza negative patients. A rapid POCT for influenza A/B and RSV infections in pediatric inpatients may improve oseltamivir prescribing, strengthen antimicrobial stewardship, reduce reimbursement charges and decrease laboratory costs.
呼吸道感染患者在感染状况得到确认之前通常进行推定治疗。我们评估了引入Enigma® MiniLab™ FluAB-RSV即时检验(POCT)对急性儿科病房中因疑似呼吸道病毒感染性疾病入院的患者的影响。本研究采用前后对照设计(2013/14呼吸道病毒流行季与2014/15呼吸道病毒流行季)。实施POCT后,流感患者的奥司他韦处方量增加(比值比[OR] = 12.7,P = 0.05,95%置信区间[CI] [1.0, 153.8])。观察到平均报销费用减少,住院时间无变化。模型显示,如果POCT成本为30英镑并用于筛查,随后对呼吸道合胞病毒(RSV)和流感检测阴性的患者进行呼吸道病毒检测组合,可实现实验室检测成本节约。儿科住院患者中针对甲型/乙型流感和RSV感染的快速POCT可能会改善奥司他韦处方情况,加强抗菌药物管理,降低报销费用并减少实验室成本。