Markussen Dagfinn Lunde, Grewal Harleen M S, Knoop Siri Tandberg, Serigstad Sondre, Kommedal Øyvind, Ebbesen Marit, Ulvestad Elling, Bjørneklett Rune
Emergency Care Clinic, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Science, Bergen Integrated Diagnostic Stewardship Cluster, University of Bergen, Bergen, Norway.
Infect Dis (Lond). 2022 Apr;54(4):247-254. doi: 10.1080/23744235.2021.2003857. Epub 2021 Nov 30.
Respiratory tract infections (RTIs) caused by contagious viruses are common among patients presenting to the emergency department (ED). Early detection of these viruses can help prevent nosocomial transmission.
To investigate the efficacy of three rapid molecular methods, namely FilmArray Pneumonia Panel plus (FAP plus), ID NOW Influenza A and B 2 (ID NOW2) point-of-care test, and an in-house real-time polymerase chain reaction (RT-PCR) test, to identify patients with viral RTIs requiring isolation in an emergency setting.
We included a FilmArray Pneumonia Panel plus in the initial workup of patients with suspected RTIs during a flu season. The RT-PCR and the influenza point-of-care test were performed as part of routine diagnostics, on demand from the treating physicians. We compared viral detections and compared time to positive test results for each method.
The FAP plus significantly reduced the turnaround time and was able to identify 95% patients with potential contagious viral RTI. Routine diagnostics ordered by the treating physician had a turnaround time of a median 22 h and detected 87% of patients with potential contagious viral RTI. In patients that had all three tests, the ID NOW2 detected 62% of patients with influenza.
The FAP plus was able to rapidly and reliably identify patients with potential contagious viral RTIs; its use was feasible in the ED setting. Failing to test patients with viral RTI and using tests with long turnaround time may lead to nosocomial transmission of viral infections and adverse patient outcomes.
由传染性病毒引起的呼吸道感染（RTIs）在前往急诊科（ED）就诊的患者中很常见。早期检测这些病毒有助于预防医院内传播。
研究三种快速分子检测方法，即FilmArray肺炎检测板升级版（FAP plus）、ID NOW甲型和乙型流感2（ID NOW2）即时检测以及内部实时聚合酶链反应（RT-PCR）检测，在急诊环境中识别需要隔离的病毒性呼吸道感染患者的有效性。
在流感季节，我们将FilmArray肺炎检测板升级版纳入疑似呼吸道感染患者的初始检查中。RT-PCR和流感即时检测作为常规诊断的一部分，根据主治医生的要求进行。我们比较了病毒检测结果，并比较了每种方法获得阳性检测结果的时间。
FAP plus显著缩短了周转时间，能够识别95%的潜在传染性病毒性呼吸道感染患者。主治医生安排的常规诊断周转时间中位数为22小时，检测出87%的潜在传染性病毒性呼吸道感染患者。在进行了所有三项检测的患者中，ID NOW2检测出62%的流感患者。
FAP plus能够快速、可靠地识别潜在传染性病毒性呼吸道感染患者；在急诊环境中使用是可行的。未对病毒性呼吸道感染患者进行检测以及使用周转时间长的检测方法可能会导致病毒感染的医院内传播和不良患者结局。
