Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK; Clinical Informatics Research Unit, University of Southampton, Southampton, UK.
J Infect. 2023 Dec;87(6):516-523. doi: 10.1016/j.jinf.2023.09.012. Epub 2023 Oct 5.
COVID-19 has caused significant challenges for infection prevention measures and patient flow in hospital admission pathways. We aimed to assess the impact of replacing laboratory PCR with molecular point-of-care testing (mPOCT) for respiratory viruses including SARS-CoV-2, within an Acute Oncology Service (AOS).
This pre- and post-implementation study took place in the AOS of a large teaching hospital, in Southampton, UK. We collected data from two periods: November 25th, 2019 to November 24th, 2020, when respiratory virus testing utilised laboratory PCR, and December 1st, 2020 to May 31st, 2021 following the introduction of mPOCT. The primary outcome was the time to results.
2189 patients were tested in the pre-implementation period and 1540 in the post implementation period. Median (IQR) time to results was 5.8 h (4.2-10.6) pre-implementation and 1.9 h (1.5-3.0) post-implementation (difference -3.6 h [95%CI to -3.8 to -3.5]; p < 0.0001). Median time spent in assessment areas was 6.0 h (4.1-7.9) pre-implementation and 5.5 h (3.8-7.4) post-implementation (p < 0.0001). 20 (0.9%) patients admitted via AOS assessment unit developed hospital-acquired respiratory virus infection pre-implementation versus 0 (0%) post-implementation (p = 0.031).
Routine mPOCT for respiratory viruses, including SARS-CoV-2, was associated with a reduced time to results, reduced time in assessment areas, and a reduction in the rates of hospital-acquired respiratory virus infection in an acute oncology assessment unit.
COVID-19 对医院入院途径中的感染预防措施和患者流程造成了重大挑战。我们旨在评估在英国南安普顿一家大型教学医院的急性肿瘤科服务（AOS）中，用分子即时检测（mPOCT）替代针对呼吸道病毒（包括 SARS-CoV-2）的实验室聚合酶链反应（PCR）的影响。
本研究为在实施前后进行的研究，在英国南安普顿一家大型教学医院的 AOS 中进行。我们从两个时期收集数据：2019 年 11 月 25 日至 2020 年 11 月 24 日，当时呼吸道病毒检测使用实验室 PCR；2020 年 12 月 1 日至 2021 年 5 月 31 日，引入 mPOCT 后。主要结果是检测结果的时间。
在实施前的时期测试了 2189 例患者，在实施后的时期测试了 1540 例患者。实施前中位数（IQR）检测结果时间为 5.8 小时（4.2-10.6），实施后为 1.9 小时（1.5-3.0）（差异-3.6 小时[95%CI -3.8 至-3.5]；p<0.0001）。实施前评估区的中位停留时间为 6.0 小时（4.1-7.9），实施后为 5.5 小时（3.8-7.4）（p<0.0001）。在实施前的 AOS 评估单位中，有 20 名（0.9%）经评估单位入院的患者发生医院获得性呼吸道病毒感染，而实施后的 0 名（0%）患者发生感染（p=0.031）。
针对呼吸道病毒（包括 SARS-CoV-2）的常规 mPOCT 与检测结果时间缩短、评估区停留时间缩短以及急性肿瘤评估单位医院获得性呼吸道病毒感染率降低有关。
