POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM

DOI:

https://doi.org/10.17564/2316-3798.2023v9n2p232-244

Autores

  • Fernanda Marçolla Weber Universidade de Caxias do sul
  • Rodrigo Schrage Lin Universidade de Caxias do Sul
  • Lessandra Michelin Universidade de Caxias do Sul

Publicado

2023-05-18

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Edição

v. 9 n. 2 (2023): Fluxo Contínuo

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Copyright (c) 2023 Interfaces Científicas - Saúde e Ambiente

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Resumo

Influenza and respiratory syncytial virus (RSV) infection are common causes of lower airway diseases. Rapid tests (antigen-based by immunochromatographic and molecular technique - RIT and RMT, respectively) with good diagnostic accuracy directly impacts the quality of patient care and hospitalization costs. This study aims to evaluate the implementation of point of care PCR (RMT) compared to rapid antigen-based tests (RIT) for influenza and RSV in the emergency department.
Prospective cross section study in an Emergency Room (ER) from August to September 2019, where all patients with influenza like illness went through RIT and RMT. The patients were divided in a model of four clinical scenarios to evaluate cost and isolation time in the ER. Four hundred and twenty fourpatients were included in the study. RIT showed sensitivity of only 40% compared with RMT (100% specificity; PPV 100%; NPV 68,7%), causing 103 patients to mistakenly leave respiratory isolation, raising biological risk in the ER. Fast results from RMT led negative patients to leave isolation early (262:10 less hours of isolation), allowing cost reduction of USD 1.921,20. Nonetheless, RMT had higher cost than RIT in all clinical scenarios with an increase of USD 12.788,90 (69,9% of cost related to tests and isolation precautions). RIT had a lower direct cost, and due to the variation in sensitivity, it should not be indicated to exclude viral respiratory diseases, which may result in biological risk for the hospital environment. RMT had better diagnostic performance with faster results, allowing for less isolation time per patient tested.

Biografia do Autor

Fernanda Marçolla Weber, Universidade de Caxias do sul

Graduation in Medicine at the University of Santa Cruz do Sul - UNISC (2014); Medical Residency in Infectology at the Hospital Geral de Caxias do Sul (2018). She is currently Assistant Professor of Infectology at the University of Caxias do Sul; Coordinator of the ICCH of the Hospital Beneficente São Pedro de Garibaldi; Master in Health Sciences (2022) at the University of Caxias do Sul. --x-- M.D. degree from the Universidade de Santa Cruz do Sul - UNISC (2014); Residency in Infectious Diseases at General Hospital of Caxias do Sul (2018). Currently working as Assistant Professor of Infectious Diseases in the Division of Clinical Medicine at University of Caxias do Sul/ Brazil (UCS) and Coordinator of Epidemiology Center at Hospital Beneficente São Pedro de Garibaldi. Master degree (2022) on Health Sciences at Caxias do Sul University

 

Rodrigo Schrage Lin, Universidade de Caxias do Sul

Medical Doctor graduated from Gama Filho University (2005), Medical Residency in Infectology at Hospital Naval Marcílio Dias (2011), postgraduate degree in Occupational Medicine from Estácio de Sá University (2011), Master's Degree in Clinical Research in Infectious Diseases at INI-Fiocruz (2015). Specialist in Infectology from the Brazilian Society of Infectology (2019). Board of Directors of the Society of Infectology of the State of Rio de Janeiro (SIERJ 2017-2020). Board of Directors of the Association for Studies in Hospital Infection Control of the State of Rio de Janeiro (AECIHERJ 2017-2018). Works in clinical infectology and hospital infection control. Experience in team coordination and clinical research. Research area: Control of hospital infection, Computing Applied to Health Sciences, Microbiology Physician graduated at Gama Filho University (2005), Medical Residency in Infectious Diseases at Hospital Naval Marcílio Dias (2011), postgraduate degree in Occupational Medicine at Estácio de Sá University (2011), Master in Clinical Research in Infectious Diseases at INI-Fiocruz (2015). Specialist in Infectious Diseases by the Brazilian Society of Infectious Diseases (2019). Rio de Janeiro State Society of Infectious Diseases (SIERJ 2017-2020). Board of the Association for Studies in Hospital Infection Control of the State of Rio de Janeiro (AECIHERJ 2017-2018). Practice in clinical infectious diseases and hospital infection control. Experience in team coordination and clinical research. Research area: Hospital infection control, Computing applied to health sciences, Microbiology

Lessandra Michelin, Universidade de Caxias do Sul

M.D. degree from the Universidade Federal de Ciências da Saúde de Porto Alegre-UFCSPA (1997); Residency in Infectious Diseases at Universidade Federal de Ciências da Saúde de Porto Alegre -Complexo Hospitalar Santa Casa de Porto Alegre (2000); Post-graduation in Medical Auditor at Gama Filho University-RJ (2004); Master degree (2003) and Doctoral degree (2008) on Biotechnology (Microbiology) at Caxias do Sul University; Advanced Course of Vaccinology at Fondation Mérieux & Université de Genève (2013); Hospital Epidemiology and Infection Control at Brazilian Society of Infectious Diseases (2017). Has experience in Medicine, acting on the following subjects: Vaccinology, Travel Medicine, Antimicrobial Stewardship, Healthcare-associated Infections, and Hospital Infection Control. Currently working as Medical Manager Vaccines at GSK and Professor of Infectious Diseases, Pediatrics and Post-graduation at the University of Caxias do Sul/ Brazil (UCS), conducting orientation and training for physicians and healthcare professionals, as well as medical and postgraduate students at UCS. Former member of the Advisory Board of the Brazilian National Immunization Program (CTAI/ PNI) for the Ministry of Health (Brazil) and Former Director of the Brazilian Society of Infectious Diseases (2018-2021).

Como Citar

Marçolla Weber, F., Schrage Lin, R. ., & Michelin, L. (2023). POINT OF CARE PCR FOR INFLUENZA AND RESPIRATORY SYNCYTIAL VIRUS: FROM THE LAB TO THE EMERGENCY ROOM. Interfaces Científicas - Saúde E Ambiente, 9(2), 232–244. https://doi.org/10.17564/2316-3798.2023v9n2p232-244