Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015-2016 influenza epidemics: An interventional study

L Busson; M Bartiaux; S Brahim; D Konopnicki; N Dauby; M Gérard; P De Backer; K Van Vaerenbergh; B Mahadeb; L Mekkaoui; M De Foor; M Wautier; O Vandenberg; P Mols; J Levy; M Hallin

doi:10.1016/j.ijid.2019.03.027

Contribution of the FilmArray Respiratory Panel in the management of adult and pediatric patients attending the emergency room during 2015-2016 influenza epidemics: An interventional study

Int J Infect Dis. 2019 Jun:83:32-39. doi: 10.1016/j.ijid.2019.03.027. Epub 2019 Mar 26.

Authors

L Busson¹, M Bartiaux², S Brahim², D Konopnicki³, N Dauby³, M Gérard³, P De Backer⁴, K Van Vaerenbergh⁴, B Mahadeb⁵, L Mekkaoui⁵, M De Foor⁵, M Wautier⁶, O Vandenberg⁷, P Mols², J Levy⁴, M Hallin⁵

Affiliations

¹ Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium. Electronic address: laurent.busson@lhub-ulb.be.
² Department of Emergency Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
³ Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
⁴ Pediatric Department, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
⁵ Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium.
⁶ Department of Molecular Diagnostic, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium.
⁷ Department of Microbiology, Laboratoire des Hôpitaux Universitaires Bruxellois, Brussels, Belgium; Infectious Diseases Epidemiological Unit, Public Health School, Université Libre de Bruxelles, Brussels, Belgium.

Abstract

Aim: To evaluate the contribution of a multiplex PCR for respiratory viruses on antibiotic and antiviral prescription, ancillary test prescription, admission and length of stay of patients.

Methods: Two hundred ninety-one adult and pediatric patients visiting the emergency department during the 2015-2016 influenza epidemic were prospectively included and immediately tested 24/7 using the FilmArray Respiratory Panel. The results were communicated to the practitioner in charge as soon as they became available. Clinical and biological data were gathered and analyzed.

Findings: Results from the FilmArray Respiratory Panel do not appear to impact admission or antibiotic prescription, with the exception of a lower admission rate for children who tested positive for influenza B. Parameters that account for the clinical decisions evaluated are CRP level, white blood cell count, suspected or proven bacterial infection and, for adult patients only, signs of respiratory distress. Length of stay is also not significantly different between patients with a positive and a negative result. A rapid influenza test result permits a more appropriate prescription of oseltamivir.

Keywords: Antibiotic; Antiviral; FilmArray Respiratory Panel; Influenza; Length of stay; Patient management; Respiratory viruses.

MeSH terms

Adolescent
Adult
Aged
Anti-Bacterial Agents / therapeutic use
Antiviral Agents / therapeutic use
Child
Child, Preschool
Emergency Service, Hospital
Epidemics*
Female
Humans
Infant
Influenza, Human / diagnosis*
Influenza, Human / drug therapy
Influenza, Human / epidemiology
Length of Stay
Male
Middle Aged
Multiplex Polymerase Chain Reaction / methods*
Prospective Studies
Respiratory Tract Infections / virology*
Time Factors
Young Adult

Substances

Anti-Bacterial Agents
Antiviral Agents