Abstract
BackgroundInfluenza viruses is a leading cause of acute respiratory infection, placing a significant burden on healthcare. To reduce hospital transmission, patients clinically suspected of having influenza are isolated and offered empirical antiviral treatment. Here we report the use of a point of care test (POCT) for influenza viruses in an acute medical unit (AMU) at Queen Elizabeth Hospital Birmingham for patients presenting with influenza-like illness.MethodsA PCR POCT was installed on AMU in Dec 17 – Mar 18 (period 2) and used to test any patient with influenza-like illness. We conducted an evaluation against influenza virus’s data collected between Dec 16–Mar 17 (period 1) where no POCT was used. Four outcomes were measured: length of stay, oseltamivir utilisation, time to isolation and in-hospital cases of influenza viruses.ResultsThere were 51 confirmed influenza virus cases in period 1 vs 666 in period 2. During period 2, the length of stay of patients presenting with influenza-like illness (2.4 vs 7.9 days) and time to isolation from receipt of a positive result (0.09 vs 1.26 days) was significantly shorter. The time to initial receipt of antivirals for patients with influenza virus was significantly quicker in period 2 (0.59 vs 1.1 days) and the total number of influenza virus cases identified after 72 h of admission was significantly lower (9% vs 51%).DiscussionFollowing introduction of the POCT, there was an increase in appropriately targeted oseltamivir prescribing, shorter time to isolation, proportionally less post-72-h influenza virus cases and a reduction in length of stay of patients presenting with influenza-like illness.ConclusionsRoutine use of POCTs for viruses should be introduced into diagnostic pathways for acute respiratory illness, especially at the front door of hospitals.
Highlights
Influenza viruses is a leading cause of acute respiratory infection, placing a significant burden on healthcare
Queen Elizabeth Hospital Birmingham (QEHB) influenza seasons In period 2 there were 256 laboratory confirmed cases of influenza A and 408 laboratory cases of influenza B, of which two patients were dually infected with both viruses
Administration of antivirals The time to initial receipt of antivirals for patients with influenza virus was quicker in period 1, with a median of 0.6 days; compared to period 1, with a median of 1.06 days (Fig. 3)
Summary
Influenza viruses is a leading cause of acute respiratory infection, placing a significant burden on healthcare. Influenza viruses is a leading cause of acute respiratory infection. It is responsible for a large burden of disease, including serious complications in patients with risk factors such as pregnancy, young children, elderly, or those with underlying medical conditions [1, 2]. Prevention of influenza virus transmission within healthcare facilities requires a multipronged approach, including general precautions such as correct hand hygiene, respiratory etiquette, patient specific contact/droplet precautions, vaccination of patients and staff, antiviral treatment or chemoprophylaxis and surveillance of cases [7, 8]. Rapid detection and implementation of chemoprophylaxis within hospitals has been identified as one of the most important interventions to contain an influenza virus outbreak [9]
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