Effect of rapid diagnosis of influenza virus type A on the emergency department management of febrile infants and toddlers
Effect of rapid diagnosis of influenza virus type A on the emergency department management of febrile infants and toddlers
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DOI：
10.1001/archpedi.156.1.41
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发表时间：
2002-01-01
影响因子：
--
通讯作者：
Simon, SD
中科院分区：
文献类型：
--
作者：
Sharma, V;Dowd, MD;Simon, SD
背景资料：有证据表明，使用酶联免疫吸附试验快速检测流感可减少儿科患者治疗中的抗生素使用。据我们所知，在急诊科（艾德）的其他诊断测试的影响还没有被examined.Objective：确定流感病毒A型的快速诊断的影响，在一个城市儿童hospital.Materials和方法的儿科艾德的临床管理发热的婴儿和幼儿：从电子数据库中的艾德记录进行了回顾性分析。本研究纳入了1998年11月1日至2000年4月30日期间，所有2至24个月大、体温高于39 ℃、使用酶联免疫吸附试验检测A型流感病毒阳性的儿童（n = 72）。结果：早期诊断组47例（65%），晚期诊断组25例（35%）。各组在年龄、体温和分诊类别方面相似。早期诊断组接受头孢曲松钠治疗的患者少于晚期诊断组（2% vs 24%，P= 0.006）;尿分析较少（2% vs 24%，P = 0.006）和全血细胞计数（17%对44%，P=.02）。快速确认流感病毒A型感染似乎可以减少ED中发热婴儿和幼儿的辅助检查和抗生素使用。需要一个更大规模的前瞻性研究来证实这些发现。
Background: Evidence shows that the rapid detection of influenza using an enzyme-linked immunosorbent assay decreases antibiotic use in the treatment of pediatric patients. To our knowledge, the effect on other diagnostic testing in an emergency department (ED) has not been examined.Objective: To determine the effect of rapid diagnosis of influenza virus type A on the clinical management of febrile infants and toddlers in a pediatric ED at an urban children's hospital.Materials and Methods: A retrospective review of ED records from an electronic database was performed. All children 2 to 24 months of age, with a temperature higher than 39degreesC who had a positive influenza virus type A test result using an enzyme-linked immunosorbent assay from November 1, 1998, through April 30, 2000 (n = 72), were included in this study. Two groups were compared-those who had positive test results reported before discharge from the ED (early diagnosis) and those who had positive test results after discharge (late diagnosis).Results: Forty-seven patients (65%) were in the early diagnosis group and 25 (35%) in the late diagnosis group. The groups were similar for age, temperature, and triage category. Fewer patients in the early diagnosis group received ceftriaxone sodium compared with those in the late diagnosis group (2% vs 24%, P=.006); there were fewer urinalyses (2% vs 24%, P =.006) and complete blood cell counts performed (17% vs 44%, P=.02).Conclusions: Rapid confirmation of influenza virus type A infection seems to decrease ancillary tests and antibiotic use in febrile infants and toddlers in the ED. A prospective study with a larger group is needed to confirm these findings.