278. Successful Implementation of a 24/7 Molecular Assay for the Diagnosis of Influenza A/B and RSV at Children's Hospital Los Angeles
Session: Poster Abstract Session: Diagnostic Microbiology; Novel Molecular Methods
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Influenza is associated with high morbidity and mortality and accurate and rapid laboratory diagnosis is necessary for appropriate management. Due to the low sensitivity and specificity of rapid antigen testing for influenza, we replaced rapid testing in early 2012 with a molecular assay performed in the Virology laboratory Monday to Saturday, between 7am to 5pm. With the impending high influenza activity expected for the 2012-13 respiratory season, testing efforts were combined between the Virology and Microbiology laboratory to offer 24/7 service starting January 1, 2013.  

Methods: 2446 patients were tested for Influenza A/B (FluA/B) and Respiratory syncytial virus (RSV) between October, 2012 to April, 2013. Real-time RT-PCR was performed on all specimens using the SimplexaTM FluA/B & RSV Direct kit (Focus Diagnostics). Testing was carried out in the Microbiology laboratory between 5pm – 7am Monday – Saturday and all day Sunday. Average turn-around-time (TAT), prevalence and impact of 24/7 service were assessed.

Results: The sensitivity and specificity of the FluA/B & RSV were previously determined to be 100% compared to alternate molecular test. Specimens validated for testing included nasopharyngeal (NP) swabs, NP wash, endotracheal aspirates, and bronchoalveolar. Of the 2446 patients tested for FluA/B and RSV, 1894 of which were tested after implementation of 24/7 service. 176 (7.2%) FluA, 152 (6.2%) FluB, and 422 (17.3%) RSV were detected by molecular method. The average turn-around-time (TAT) decreased from 16 hours to 3 hours; TAT was 2 hours in March. Of the 328 patients positive for FluA/B, 118 (36.0%) were admitted to CHLA with appropriate isolation.

Conclusion: Joint efforts between the Microbiology and Virology laboratories at CHLA allowed for the successful implementation of 24/7 molecular testing of FluA/B and RSV in lieu of a rapid antigen test. This 24/7 service provided detection results to clinicians in a timely manner without compromising sensitivity and accuracy.

Maryann Lustestica1, Daryl Strano1, Aileen Delos Angeles1, Claudia Michelle Polanco1, Gennie Lam1 and Jennifer Dien Bard2, (1)Children's Hospital Los Angeles, Los Angeles, CA, (2)Pathology and Laboratory Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA

Disclosures:

M. Lustestica, None

D. Strano, None

A. Delos Angeles, None

C. M. Polanco, None

G. Lam, None

J. Dien Bard, None

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