Accuracy and impact of a point-of-care rapid influenza test in young children with respiratory illnesses
Accuracy and impact of a point-of-care rapid influenza test in young children with respiratory illnesses
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DOI：
10.1001/archpedi.160.7.713
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发表时间：
2006-07-01
影响因子：
--
通讯作者：
Edwards, K
中科院分区：
文献类型：
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作者：
Poehling, KA;Zhu, YW;Edwards, K
目的：确定床旁快速流感检测是否影响急性呼吸道疾病儿童的诊断评估和治疗。设计：随机对照试验。设置：儿童医院的儿科急诊科和急性护理门诊。参与者：在2个流感季节期间有发热或急性呼吸道症状的5岁以下儿童干预措施：监测天数随机分配至进行或不进行即时快速流感检测。所有儿童均采集鼻和咽拭子进行实验室检查。快速测试组有另一个鼻拭子获得的QuickVue流感测试（Quidel公司，圣地亚哥，加利福尼亚州），这是由护士进行的;结果立即与治疗physics.Main结果Measures：快速测试结果进行了比较，结果的病毒培养或2聚合酶链反应检测流感。结果：在468名入选儿童中，306名来自急诊科，162名来自门诊。总体而言，88名儿童（19%）感染了流感。在快速检测组的205名儿童中，51名（25%）感染了流感。快速流感检测的敏感性为82%，特异性为99%。在急诊科，快速检测组的儿童比非快速检测组的儿童更少（39% vs 51%，P= 0.03）。两种情况下的门诊检查顺序或抗生素处方没有差异。使用抗病毒药物是low.Conclusions：点的护理快速流感测试是敏感和特异性，并与急诊科较少的诊断测试。
Objective: To determine whether a point-of-care rapid influenza test impacts the diagnostic evaluation and treatment of children with acute respiratory illnesses.Design: Randomized controlled trial.Setting: Pediatric emergency department and acute care clinic of a children's hospital.Participants: Children aged younger than 5 years with fever or acute respiratory symptoms during 2 influenza seasons ( 2002 through 2004).Interventions: Surveillance days were randomized to performance or no performance of a point-of-care rapid influenza test. All children had a nasal and throat swab obtained for laboratory tests. The rapid test group had another nasal swab obtained for the QuickVue Influenza Test (Quidel Corp, San Diego, Calif), which was performed by nurses; results were shared immediately with treating physicians.Main Outcome Measures: Rapid test results were compared with results of the viral culture or 2 polymerase chain reaction assays for influenza. Diagnostic test ordering and antibiotic prescribing were compared for the groups.Results: Of 468 enrolled children, 306 were from the emergency department and 162 from the clinic. Overall, 88 children (19%) had influenza infection. Of 205 children in the rapid test group, 51 (25%) had influenza infection. The rapid influenza test was 82% sensitive and 99% specific. In the emergency department, fewer children in the rapid test group had diagnostic tests ordered than in the no rapid test group (39% vs 51%, P=.03). There was no difference in test ordering in the clinic or in antibiotic prescribing in either setting. The use of antivirals was low.Conclusions: Point-of-care rapid influenza tests were sensitive and specific and were associated with less diagnostic testing in the emergency department.