Program Schedule

1428
Impact of Rapid Influenza PCR Testing on Inpatient Clinical Outcomes

Session: Poster Abstract Session: Diagnostic Microbiology: Viruses/Fungal/AFB/Parasitic
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • RapidFlu_IDSA20141001_SEND.pdf (1.6 MB)
  • Background: Early diagnosis of influenza leads to improved infection control and early initiation of antiviral therapy. Rapid antigen testing is limited by poor sensitivity. Few data exist to evaluate the effect of rapid polymerase chain reaction (PCR) testing on patient outcomes.

    Methods: A retrospective cohort study of 150 consecutive hospitalized patients from two respiratory viral seasons was performed using chart review to compare baseline sociodemographic characteristics as well as clinical outcomes before (Season 1: 2012) and after (Season 2: 2013) implementation of a rapid RSV/influenza PCR test vs. previous send out PCR testing at the University of Washington and Harborview Medical Centers.

    Results: The majority of hospitalized patients with testing performed had comorbid conditions, including 73 (24%) with underlying pulmonary disease. A total of 156 (52%) patients reported influenza vaccination. Influenza was detected in 9 (6%) patients in Season 1 and 31 (21%) in Season 2. The median time between sample collection and reporting of results in Season 1 was 28 vs 2 hours in Season 2 (P<0.001). In Season 2, empiric therapy with oseltamivir was more likely to be initiated (42% in Season 1 vs. 59% in Season 2; P=0.004), and antiviral duration was shorter in patients who were influenza negative (1.4 days in Season 1 vs. 0.73 days in Season 2; P=0.05) compared to Season 1. No difference was found in hospitalization duration (11 days vs. 12 days; P=0.56) or antibiotic use (83% vs. 81%; P=0.55) between the two seasons.  

    Conclusion: Despite a significant decrease in time to result with the implementation of rapid influenza PCR testing, no difference was observed in frequency of antibiotic use or duration of hospitalization. Initiation of oseltamivir was more frequent though overall duration of antiviral therapy was shorter in patients who tested influenza negative by rapid testing in Season 2. This suggests that unnecessary antiviral use may be decreased with implementation of rapid testing for influenza in an inpatient setting.

    Helen Y. Chu, MD MPH1, Jane Kuypers, PhD2, Timothy H. Dellit, MD3, Jeannie Chan, PharmD, MPH4, John B. Lynch, MD MPH3, Rupali Jain, PharmD5, Paul Pottinger, MD6, Emily Martin, BS7 and Janet a. Englund, MD, FIDSA7, (1)Allergy & Infectious Diseases, University of Washington, Seattle, WA, (2)University of Washington, Seattle, WA, (3)Infection Control, Harborview Medical Center, Seattle, WA, (4)Harborview Medical Center, Seattle, WA, (5)Pharmacy, University of Washington Medical Center, Seattle, WA, (6)Division of Allergy and Infectious Disease, University of Washington, Seattle, WA, (7)Seattle Children's Hospital, Seattle, WA

    Disclosures:

    H. Y. Chu, None

    J. Kuypers, None

    T. H. Dellit, None

    J. Chan, None

    J. B. Lynch, None

    R. Jain, None

    P. Pottinger, None

    E. Martin, None

    J. A. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support
    Chimerix: Investigator, Research support
    Roche: Investigator, Research support
    GlaxoSmithKline: Consultant, Investigator and Member, DSMB (DataSafety Monitoring Board), Consulting fee, Payment for DSMB participation and Research support
    Ansun Biopharma: Investigator, Research support

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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