Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial.
Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial.
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DOI：
10.1093/jac/dkab241
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发表时间：
2021-09-23
期刊：
影响因子：
--
通讯作者：
Visseaux B
中科院分区：
文献类型：
--
作者：
Bouzid D;Casalino E;Mullaert J;Laurent O;Duval X;Lescure FX;Peiffer Smadja N;Tubiana S;Armand Lefèvre L;Descamps D;Fidouh N;Choquet C;Lucet JC;Visseaux B
随着SARS-CoV-2的出现和多重PCR（mPCR）的广泛使用，病毒相关的呼吸道感染成为人们关注的焦点。分子检测作为床旁检测（POCT）在急诊科（艾德）的影响尚不清楚。比较在艾德作为POCT和在中心实验室进行的综合征检测对住院时间（LOS）、抗生素使用和单间分配的影响。从2019年11月19日至2020年3月9日，入组了在大型医院的艾德就诊的急性呼吸道疾病成人，在艾德作为POCT（A周）或在中心实验室（B周）每周交替进行mPCR。分析了474例患者：A周275例，B周199例。患者特征相似。两组住院时间（A周中位数为7天，B周中位数为7天，P = 0.29）、ED-LOS <1天的患者比例（63%对60%，P = 0.57）和艾德抗生素处方（59%对58%，P = 0.92）无显著差异。 POCT组中流感、呼吸道合胞病毒和偏肺病毒PCR阳性的患者更常被分配到单个房间[52/70（74%）vs 19/38（50%），中心检测组，P = 0.012]。 与中心实验室相比，在艾德进行的综合征检测未能减少急性呼吸道疾病患者的LOS或抗生素消耗，但与检测到显著呼吸道病原体的患者的单间分配增加相关。
Virus-associated respiratory infections are in the spotlight with the emergence of SARS-CoV-2 and the expanding use of multiplex PCR (mPCR). The impact of molecular testing as a point-of-care test (POCT) in the emergency department (ED) is still unclear. To compare the impact of a syndromic test performed in the ED as a POCT and in the central laboratory on length of stay (LOS), antibiotic use and single-room assignment. From 19 November 2019 to 9 March 2020, adults with acute respiratory illness seeking care in the ED of a large hospital were enrolled, with mPCR performed with a weekly alternation in the ED as a POCT (week A) or in the central laboratory (week B). 474 patients were analysed: 275 during A weeks and 199 during B weeks. Patient characteristics were similar. The hospital LOS (median 7 days during week A versus 7 days during week B, P = 0.29), the proportion of patients with ED-LOS <1 day (63% versus 60%, P = 0.57) and ED antibiotic prescription (59% versus 58%, P = 0.92) were not significantly different. Patients in the POCT arm were more frequently assigned a single room when having a positive PCR for influenza, respiratory syncytial virus and metapneumovirus [52/70 (74%) versus 19/38 (50%) in the central testing arm, P = 0.012]. Syndromic testing performed in the ED compared with the central laboratory failed to reduce the LOS or antibiotic consumption in patients with acute respiratory illness, but was associated with an increased single-room assignment among patients in whom a significant respiratory pathogen was detected.
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影响因子：
6.4
作者：
van Asten, Liselotte;van den Wijngaard, Cees;Koopmans, Marion
通讯作者：
Koopmans, Marion
DOI：
10.1016/s2213-2600(17)30120-0
发表时间：
2017-05
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Brendish NJ;Malachira AK;Armstrong L;Houghton R;Aitken S;Nyimbili E;Ewings S;Lillie PJ;Clark TW
通讯作者：
Clark TW
影响因子：
3.7
作者：
Andrews D;Chetty Y;Cooper BS;Virk M;Glass SK;Letters A;Kelly PA;Sudhanva M;Jeyaratnam D
通讯作者：
Jeyaratnam D
从2011年到2016年，成年人，季节，年龄，呼吸道区域以及法国巴黎的医疗单位类型的呼吸病毒患病率。
影响因子：
3.7
作者：
Visseaux B;Burdet C;Voiriot G;Lescure FX;Chougar T;Brugière O;Crestani B;Casalino E;Charpentier C;Descamps D;Timsit JF;Yazdanpanah Y;Houhou-Fidouh N
通讯作者：
Houhou-Fidouh N
北京市急诊科成年患者呼吸道病毒感染的病原学及临床特征
影响因子：
3.7
作者：
Yu X;Lu R;Wang Z;Zhu N;Wang W;Julian D;Chris B;Lu J;Tan W
通讯作者：
Tan W