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Rapid Molecular Detection and Differentiation of Influenza Viruses A and B
Published on: January 30, 2017
Rapid Influenza Diagnosis in Children With Serious Bacterial Infection-Like Symptoms
Melanie Forster1,2, Alexandra Tielli2, Anne-Aurelie Lopes3
1Emergency Department, General Hospital of Annecy, Épagny Metz-Tessy, France.
Insights
The Quidel Sofia rapid influenza diagnostic test aids in managing children with serious bacterial infection (SBI)-like symptoms. It reduces unnecessary tests and antibiotic use without missing critical SBI diagnoses, improving emergency department (ED) efficiency.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Disease Diagnostics
- Rapid Influenza Testing
Background:
- Children presenting with serious bacterial infection (SBI)-like symptoms in the emergency department (ED) often undergo extensive diagnostic workups.
- Differentiating viral infections like influenza from bacterial infections is crucial for appropriate management and resource allocation.
Purpose of the Study:
- To evaluate the impact of diagnosing influenza using the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) on the clinical management of children with SBI-like symptoms in the ED.
- To assess if rapid influenza diagnosis influences diagnostic testing, antibiotic administration, and hospitalization rates without compromising the detection of SBI.
Main Methods:
- A cohort study involving 161 children with SBI-like symptoms who were tested with the Quidel Sofia rapid influenza FIA.
- Comparison of management strategies (diagnostic tests, antibiotic use, hospitalization) between influenza-positive and influenza-negative children.
- Follow-up to confirm the absence of missed SBI cases post-discharge.
Main Results:
- Influenza-positive children received fewer diagnostic tests (58.1% vs. 90.7%) and antibiotics (10.5% vs. 33.3%) compared to influenza-negative children.
- Hospitalization rates (20.9% vs. 40%) and ED visit durations were significantly lower for influenza-positive children.
- No cases of missed SBI were observed in influenza-positive children, although one patient developed a fatal secondary SBI.
Conclusions:
- The Quidel Sofia rapid influenza FIA positively impacts the medical management of children with SBI-like symptoms by enabling targeted care.
- The test helps reduce ED overcrowding during influenza season by streamlining care for influenza cases while maintaining vigilance for bacterial co-infections.
- The diagnostic benefits are achieved without an increase in missed SBI diagnoses.
Aim:
To evaluate the impact of the influenza diagnosis by the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) on children presenting with serious bacterial infection (SBI)-like symptoms in an emergency department (ED).
Methods:
A cohort study was conducted on 161 children with SBI-like symptoms, who underwent a Quidel Sofia test. The management of Influenza-positive and Influenza-negative children was compared on diagnostic tests, antibiotic use, and hospitalisation rates. Follow-up was performed 7-10 days post-discharge to confirm SBI non-omission.
Results:
Influenza-positive children underwent fewer diagnostic tests, including fewer invasive tests, than influenza-negative children (58.1% vs. 90.7%, p < 0.001 and 47.7% vs. 72%, p = 0.002, respectively), received fewer antibiotics (10.5% vs. 33.3%, p < 0.001), had lower hospitalisation rates (20.9% vs. 40%, p = 0.008) and shorter ED visits (133 [52-257] minutes vs. 177 [92-273] minutes, p = 0.002). No influenza-positive patient had a missed SBI, even among the youngest patients. One developed a secondary SBI 4 days later resulting in death.
Conclusion:
This study demonstrated the benefit of the influenza diagnosis by Quidel Sofia rapid influenza FIA in medical management without omitting SBI in children with SBI-like symptoms. Therefore, the Quidel Sofia test can help alleviate ED overcrowding during the influenza season while maintaining vigilance for bacterial co-infection.
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