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. 2021 Sep;15(5):608-617.
doi: 10.1111/irv.12857. Epub 2021 Apr 4.

Point-of-care testing for influenza in a university emergency department: A prospective study

Benjamin Perlitz  1 , Anna Slagman  1 , Jennifer Hitzek  1 , Dorothee Riedlinger  1 , Martin Möckel  1
Affiliations

Point-of-care testing for influenza in a university emergency department: A prospective study

Benjamin Perlitz et al. Influenza Other Respir Viruses. 2021 Sep.

Abstract

Background: Seasonal influenza is a burden for emergency departments (ED). The aim of this study was to investigate whether point-of-care (POC) PCR testing can be used to reduce staff sick days and improve diagnostic and therapeutic procedures.

Objectives: The aim of this study was to investigate whether point-of-care (POC) PCR testing can be used to reduce staff sick days and improve diagnostic and therapeutic procedures.

Methods: Using a cross-over design, the cobas® Liat® Influenza A/B POC PCR test (Liat) was compared with standard clinical practice during the 2019/2020 influenza season. All adult patients (aged ≥ 18 years) with fever (≥38°C) and respiratory symptoms were included. Primary end points were the prevalence of influenza infections in the ED and staff sick days. Secondary end points were frequency of antiviral and antibacterial therapy, time between admission and test result or treatment initiation, patient disposition, ED length of stay (LOS), and for inpatients mortality and LOS. Nurses were interviewed about handling and integration of POC testing. The occurrence of SARS-CoV-2 infections coincided with the second half of the study.

Results: A total of 828 patients were enrolled in the study. All 375 patients of the intervention group were tested with Liat, and 103 patients of them (27.6%) tested positive. During the intervention period, staff sick days were reduced by 34.4% (P = .023). Significantly, more patients in the intervention group received antiviral therapy with neuraminidase inhibitors (7.2% vs 3.8%, P = .028) and tested patients received antibiotics more frequently (40.0% vs 31.6%, P = .033). Patients with POC test were transferred to external hospitals significantly more often (5.6% vs 1.3%, P = .01).

Conclusion: We conclude that POC testing for influenza is useful in the ED, especially if it is heavily frequented by patients with respiratory symptoms.

Keywords: emergency department; influenza; point-of-care testing; polymerase chain reaction; staff protection.

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Conflict of interest statement

Mr Perlitz, Ms Riedlinger, and Ms Hitzek have no conflicts of interest. Prof. Slagman reports grants from Deutsche Forschungsgemeinschaft, grants from Bundesministerium für Bildung und Forschung, grants from Zentralinstitut für die Kassenärztliche Versorgung and grants from Thermo Fisher Scientific outside the submitted work, and grants from Roche Diagnostics related to the submitted work. Prof. Möckel declares research funding from Roche Diagnostics and speaker and advisory board fees from Roche Diagnostics.

Figures

FIGURE 1
FIGURE 1
Patient recruitment. Patients were screened for fitting the criteria at two Charité sites (CVK, CCM). All included patients had to be over 18 years of age and presented with fever (≥38°C) and respiratory symptoms
FIGURE 2
FIGURE 2
Sick days of emergency department (ED) staff by study period and function. ED staff sick days distinguished between nurses and physicians during both study periods were aggregated and compared with each other
FIGURE 3
FIGURE 3
Emergency department therapy. Antibiotic therapy and therapy with antivirals (neuraminidase inhibitors) were compared between both study groups
FIGURE 4
FIGURE 4
Disposition by study groups. Disposition from the emergency department is shown for both study groups
See this image and copyright information in PMC

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