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Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
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Clinical impact of rapid diagnostics using Xpert Flu/RSV™ PCR on antimicrobial stewardship initiatives during

Ruchir Chavada1, Liam Clifford2, Owen Weisback2

  • 1NSW Health Pathology-Central Coast, Gosford, Australia.

Infection, Disease & Health
|December 10, 2019
PubMed
Abstract

Insights

Rapid influenza tests (RIT) can aid antibiotic cessation in patients. Timely RIT results, especially within 6-12 hours, significantly influence decisions to stop antibiotic use, improving antimicrobial stewardship.

Area of Science:

  • Infectious Diseases
  • Clinical Microbiology
  • Antimicrobial Stewardship

Background:

  • Limited literature exists on the impact of rapid influenza tests (RIT) on antimicrobial stewardship programs (AMS).
  • Previous studies using rapid point-of-care tests (POCT) suggest benefits in reducing antimicrobial therapy duration and antiviral prescriptions.
  • This study aimed to evaluate the effect of RIT on antibiotic cessation in influenza patients.

Purpose of the Study:

  • To assess the impact of rapid influenza testing on antibiotic cessation in patients presenting with influenza-like illness.
  • To determine if the turnaround time of rapid influenza tests influences antibiotic cessation decisions.
  • To identify patient factors associated with continued antibiotic use despite influenza diagnosis.

Main Methods:

  • A prospective study was conducted in 2017 using the Xpert Flu/RSV test for patients with influenza-like illness (ILI).
  • Clinical data were extracted from electronic medical records; patients with RSV were excluded.
  • Univariate and multivariable regression analyses were performed to evaluate the association between RIT results, turnaround time, and antibiotic cessation.

Main Results:

  • Of 665 patients testing positive for influenza, 34% had antibiotics ceased and 10% were not given antimicrobials.
  • The median turnaround time (TAT) for RIT was 7 hours, with 50% completed in under 6 hours.
  • Antibiotic cessation was significantly associated with RIT results obtained within 6-12 hours (OR 1.55, p=0.01), while continued antibiotic use was linked to immunosuppression (OR 2.88), pneumonia (OR 18.8), and COPD (OR 2.43).

Conclusions:

  • Influenza patients with underlying conditions like COPD, pneumonia, or immunosuppression are more likely to continue receiving antibiotics.
  • Rapid influenza test results delivered within 6-12 hours can effectively guide clinicians in discontinuing antibiotic therapy.
  • Implementing timely RIT can enhance antimicrobial stewardship by facilitating appropriate antibiotic cessation.
Keywords:
Antimicrobial stewardshipRapid diagnosticsRapid influenza tests

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