Clinical Impact of Rapid Diagnostics using Xpert Flu/RSV™ PCR on Antimicrobial Stewardship Initiatives during Influenza Season

Dr  Ruchir Chavada1, Dr  Liam  Clifford2, Dr  Owen Weisback2

1NSW Health Pathology, Gosford , Australia, 2Department of Medicine,Gosford/Wyong Hospital, Gosford , Australia

 

Introduction

Despite availability of several rapid Influenza tests(RIT), literature on its impact on antimicrobial stewardship programs(AMS) is minimal. Studies utilising respiratory virus PCR have shown benefit in terms of shortening antimicrobial therapy and hospital length of stay(LOS). We designed this study to assess whether RIT had an impact on antibiotic cessation.

Methods

Xpert Flu/RSV (Cepheid, CA) was done on all patients who presented with influenza like illness(ILI) in 2017. Clinical data was collected from electronic medical records(eMR). Patients with RSV were not included. Turnaround time(TAT) for test was time from specimen collection until when result was either notified or appeared on eMR. Standard univariate analysis and multivariable regression analysis(MVRA) were done.

Results

A total of 665 patients tested positive-Influenza A (63%) and B (37%). After positive results, antimicrobials were ceased in 34% (226/665) or not given in 10% (71/665) cases. Median TAT was 7 hours with 50% of tests completed in ≤ 6hours. 56%(368/665) of patients had their antibiotics continued. On MVRA, results of Flu PCR that were available in ≤ 12 hours resulted in most antibiotic cessation (73%, OR 1.55, p=0.011). It was found that antibiotics are continued in immunosuppressed patients (OR 2.88, p=0.002), pneumonia (OR 18.8, p<0.001) and COPD (OR 2.43, p=0.001).

Conclusion

In patients with ILI antibiotics are more likely to be continued when there is underlying COPD, pneumonia, or immunosuppression. In our hospitals, RIT done with a TAT of ≤12 hours was shown to avoid unnecessary antibiotic therapy, thus helping with AMS initiatives.

 


 

Biography:

Biography submitted with other abstract

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The ACIPC is the peak body for Infection Prevention and Control professionals in the Australasian region. Our stated vision is the prevention and control of infection in our communities. We commenced in January 2012 bringing together the various State and Territory infection control associations formerly in AICA (The Australian Infection Control Association) to support and encourage collaboration across Australasia.

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