261. Comparison of the impact of two multiplex respiratory panel assays on management of hospitalized children
Session: Poster Abstract Session: Diagnostic Microbiology; Novel Molecular Methods
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDSA RVP Poster 09-26-13_RS092713.pdf (3.6 MB)
  • Background: Highly multiplexed respiratory panel PCR assays currently approved for clinical diagnostics vary in number of pathogens detected and test turnaround time (TAT) for results. Luminex respiratory viral panel (RVP) detects 12 respiratory viruses with a minimum TAT of 6 hours, while FilmArray respiratory panel (RP) detects 20 respiratory pathogens in about an hour.  The aim of the current study was to compare the impact of RVP and RP assays on management of hospitalized children.

    Methods: Retrospective chart review to compare laboratory and clinical records of children in whom a multiplex respiratory viral panel PCR assay was requested. Records from January 1 to February 15, 2012, (RVP assay) were compared to same time period in 2013 (RP assay). Patients aged < 2 years and positive for at least one respiratory virus were included and deceased patients were excluded from analysis.

    Results: A total of 25 patients were positive in 2012 by RVP compared to 92 positive by RP in 2013. 52% (n=13) of samples were identified as Rhino/Enterovirus by RVP followed by RSV (36%, n=9). In 2013, 54% (n=50) samples were RSV positive by RP followed by 36% Rhino/Enterovirus (n=33). The median TAT for RVP and RP assay were 28.4 hours and 1.4 hours respectively (p < 0.001). The median length of hospitalization (LOH) for children in both RVP and RP groups were similar (4 days). Empiric antibiotic therapy was initiated in 68%  (n=17) of children in the RVP group versus 53% (n=47) in RP group.  Following PCR test reporting, antibiotic was discontinued or de-escalated in 1 patient (6%) in the RVP group versus 18 (20%) patients in the RP group. 

    Conclusion: The TAT for RP assay was superior to the RVP assay. Our results suggest that a rapid molecular test for respiratory pathogen detection may be useful to reduce and optimize antibiotic usage in hospitalized children. Timely reporting of the result to a clinical intervention team such as an antimicrobial stewardship program may further improve antibiotic utilization in this group.

    Ferdaus Hassan, PhD1, Elizabeth Rodman2, Diana Yu, PharmD, BCPS3 and Rangaraj Selvarangan, PhD1, (1)Children's Mercy Hospital and Clinics, Kansas City, MO, (2)University of Missouri-Kansas City, School of Pharmacy, Kansas City, MO, (3)Children's Mercy Hospitals and Clinics, Kansas City, MO

    Disclosures:

    F. Hassan, None

    E. Rodman, None

    D. Yu, None

    R. Selvarangan, BioFire Diagnostics, Inc: Scientific Advisor, Consulting fee

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.