Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use
OBJECTIVES: Acute respiratory infections(ARIs) are the leading causes of child mortality.Early and appropriate treatment is critical.Antibiotic prescribing rates are high,because bacterial infections cannot be excluded based on clinical findings alone.Rapid identification of microorganism is critica...
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| Language: | English |
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Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S221371652400256X |
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| author | Sultan Gülbahçe Orhan Ayse Esra Karakoç Burcu Ceylan Cura Yayla Medine Ayşin Taşar |
| author_facet | Sultan Gülbahçe Orhan Ayse Esra Karakoç Burcu Ceylan Cura Yayla Medine Ayşin Taşar |
| author_sort | Sultan Gülbahçe Orhan |
| collection | DOAJ |
| description | OBJECTIVES: Acute respiratory infections(ARIs) are the leading causes of child mortality.Early and appropriate treatment is critical.Antibiotic prescribing rates are high,because bacterial infections cannot be excluded based on clinical findings alone.Rapid identification of microorganism is critical.Because rapid identification tests are expensive,laboratories need to develop cost-effective algorithms.In this study,it was aimed to evaluate the clinical outcomes of implementing SARS-CoV-2/Influenza/RSV PCR panel as a screening step. MATERIALS-METHODS: This study was conducted in two consecutive seasons:Season 1(n=256) and Season 2(n=267).In Season 1,patients tested for respiratory viruses with routine respiratory PCR(Anatolia,Turkey).To shorten test turnaround time(TAT),respiratory tract samples were collected with a sampling and rapid Viral RNA Isolation Kit(Anatolia,Turkey) and tested with a single tube SARS-CoV-2/Flu/RSV Rt-PCR Panel Kit (Anatolia,Turkey) in Season 2. This test was used as a screening panel.All results were reported as critical result to the clinician.Impacts of critical result reporting on patient care were evaluated.Outcomes were diagnostic test utilization,antimicrobial prescribing and discontinuation rates,cost-savings-per-test. RESULTS: TAT was 20h shorter in Season 2.Of the patients,45%received test results during their stay in the emergency department.For patients with positive results, the number of blood and urine cultures;prescription and duration of empirical antibiotic therapy decreased significantly compared to Season 1.De-escalation of antimicrobial following the results has increased.Antiviral prescription was increased in patients positive for influenza.Time to first dose of antiviral was shortened by 29hours.Cost-saving-per-test was 12$.In order to implement this algorithm cost-effectively,it was considered that it should be implemented when overall prevalence of three viruses is above19,04%. CONCLUSION: Rapid and cost-effective identification of the microorganism is critical for clinical decision-making. |
| format | Article |
| id | doaj-art-0d74134c64de428db3ea920d7edb5b7d |
| institution | DOAJ |
| issn | 2213-7165 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj-art-0d74134c64de428db3ea920d7edb5b7d2025-08-20T02:53:16ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01392610.1016/j.jgar.2024.10.079Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial UseSultan Gülbahçe Orhan0Ayse Esra Karakoç1Burcu Ceylan Cura Yayla2Medine Ayşin Taşar3Manisa City HospitalDepartment of Clinical Microbiology, Ankara Training and Research HospitalDepartment of Pediatrics, Ankara Training and Research HospitalDepartment of Pediatrics, Ankara Training and Research HospitalOBJECTIVES: Acute respiratory infections(ARIs) are the leading causes of child mortality.Early and appropriate treatment is critical.Antibiotic prescribing rates are high,because bacterial infections cannot be excluded based on clinical findings alone.Rapid identification of microorganism is critical.Because rapid identification tests are expensive,laboratories need to develop cost-effective algorithms.In this study,it was aimed to evaluate the clinical outcomes of implementing SARS-CoV-2/Influenza/RSV PCR panel as a screening step. MATERIALS-METHODS: This study was conducted in two consecutive seasons:Season 1(n=256) and Season 2(n=267).In Season 1,patients tested for respiratory viruses with routine respiratory PCR(Anatolia,Turkey).To shorten test turnaround time(TAT),respiratory tract samples were collected with a sampling and rapid Viral RNA Isolation Kit(Anatolia,Turkey) and tested with a single tube SARS-CoV-2/Flu/RSV Rt-PCR Panel Kit (Anatolia,Turkey) in Season 2. This test was used as a screening panel.All results were reported as critical result to the clinician.Impacts of critical result reporting on patient care were evaluated.Outcomes were diagnostic test utilization,antimicrobial prescribing and discontinuation rates,cost-savings-per-test. RESULTS: TAT was 20h shorter in Season 2.Of the patients,45%received test results during their stay in the emergency department.For patients with positive results, the number of blood and urine cultures;prescription and duration of empirical antibiotic therapy decreased significantly compared to Season 1.De-escalation of antimicrobial following the results has increased.Antiviral prescription was increased in patients positive for influenza.Time to first dose of antiviral was shortened by 29hours.Cost-saving-per-test was 12$.In order to implement this algorithm cost-effectively,it was considered that it should be implemented when overall prevalence of three viruses is above19,04%. CONCLUSION: Rapid and cost-effective identification of the microorganism is critical for clinical decision-making.http://www.sciencedirect.com/science/article/pii/S221371652400256XAcute respiratory infectionsInfluenzamultiplex PCRRSVdiagnostic algorithmantimicrobial stewardship |
| spellingShingle | Sultan Gülbahçe Orhan Ayse Esra Karakoç Burcu Ceylan Cura Yayla Medine Ayşin Taşar Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use Journal of Global Antimicrobial Resistance Acute respiratory infections Influenza multiplex PCR RSV diagnostic algorithm antimicrobial stewardship |
| title | Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use |
| title_full | Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use |
| title_fullStr | Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use |
| title_full_unstemmed | Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use |
| title_short | Impact of SARS CoV-2 / Influenza A & B / RSV Multiplex PCR Screening Algorithm on Patient Management and Antimicrobial Use |
| title_sort | impact of sars cov 2 influenza a amp b rsv multiplex pcr screening algorithm on patient management and antimicrobial use |
| topic | Acute respiratory infections Influenza multiplex PCR RSV diagnostic algorithm antimicrobial stewardship |
| url | http://www.sciencedirect.com/science/article/pii/S221371652400256X |
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