1866. Role of Respiratory Virus Panels in Antimicrobial Stewardship in Immunocompromised Patients
Session: Poster Abstract Session: Antibiotic Stewardship: Diagnostics
Saturday, October 29, 2016
Room: Poster Hall
  • Mercuro_Biofire_IDWeek2016.pdf (298.3 kB)
  • Background: Respiratory virus (RV) panels have emerged as a novel method for detecting influenza and pathogens known to cause influenza-like-illness which may have clinical relevance in immunocompromised patients. The purpose of this study was to describe turnaround time (TAT) and antimicrobial stewardship interventions associated with in-house RV testing compared to send-out testing in an immunocompromised population.

    Methods: This was an IRB-approved, pretest-posttest quasiexperiment at an 802-bed hospital in Detroit MI. Inpatients ≥18 years of age with solid organ and bone marrow transplant, or those with immunocompromising conditions in the intensive care unit (ICU) were included. Collection periods were RV season 1 (RVS1), Oct. 2014—Mar. 2015 (send-out testing), and RV season 2 (RVS2), Oct. 2015—Apr. 2016 (in-house testing). TAT was measured from specimen collection to result; time to intervention (TTI) was measured from specimen collection to change in drug therapy. RVS1 and RVS2 were compared using bivariate tests.

    Results: 131 patients were included, 56 RVS1, 75 RVS2. 61.1% of patients were clinically diagnosed with pneumonia, 27.5% of which was microbiologically confirmed. The in-house panel reduced TAT and TTI, and had more positive testing (Table 1). Most common pathogens were influenza (8 in RVS1, 5 in RVS2), coronavirus (0 and 11), and rhinovirus (1 and 7). Differences were not observed between groups for frequency or type of intervention or outcome.

    Conclusion: Diagnostic yield and TTI were improved by in-house RV testing, but this did not impact length of stay (LOS), duration of therapy (DOT), or frequency of drug-related interventions. The majority of interventions were discontinuation of oseltamivir, with minimal impact on antibacterial use.


    RVS1 (n=56)

    RVS2 (n=75)


    Positive test, n (%)

    11 (19.6)

    32 (42.7)

    < 0.01

    TAT, median hrs (IQR)

    47 (11—61)

    6 (3.5—11)

    < 0.001

    TTI, median hrs (IQR)

    52 (38—69)

    14( 9—30)

    < 0.001

    DOT, median days (IQR)

    4 (2—7)

    4 (2—7)


    LOS, median days (IQR)

    8 (4—14)

    6 (3—13.5)


    Intervention, n (%)

    20 (35.7)

    23 (30.6)


    Start antiviral

    3 (5.4)

    7 (9.3)


    Discontinue oseltamivir

    14 (25.0)

    13 (17.3)


    Discontinue antibiotic

    2 (3.6)

    4 (5.3)


    Adjust immunosuppression

    1 (1.8)

    2 (2.7)









    Nicholas Mercuro, PharmD1, Rachel M Kenney, PharmD2, Robert Tibbetts, Ph.D. D(ABMM), F(CCM)1, Linoj Samuel, PhD., D(ABMM)1 and Susan L Davis, PharmD1,3, (1)Henry Ford Hospital, Detroit, MI, (2)Pharmacy, Henry Ford Hospital, Detroit, MI, (3)Wayne State University College of Pharmacy, Detroit, MI


    N. Mercuro, None

    R. M. Kenney, None

    R. Tibbetts, None

    L. Samuel, None

    S. L. Davis, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.