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首页> 外文期刊>BMC Infectious Diseases >Multiplex PCR point of care testing versus routine, laboratory-based testing in the treatment of adults with respiratory tract infections: a quasi-randomised study assessing impact on length of stay and antimicrobial use
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Multiplex PCR point of care testing versus routine, laboratory-based testing in the treatment of adults with respiratory tract infections: a quasi-randomised study assessing impact on length of stay and antimicrobial use

机译：多重PCR关心测试与常规，实验室的测试在治疗呼吸道感染的成人中：准随机研究评估对住院时间和抗菌用途的影响

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Background Laboratory-based r espiratory pathogen (RP) results are often available too late to influence clinical decisions such as hospitalisation or antibiotic treatment due to time delay in transport of specimens and testing schedules. Ward-based i.e. point of care (POC) testing providing rapid results may alter the clinical management pathway. Methods FilmArray? RP polymerase chain reaction (PCR) systems were placed in three in-patient and out-patient medical areas. Patients presenting with influenza-like illness /upper respiratory tract infection +/? lower RTI were recruited between January–July 2015. FilmArray? POC testing occurred on even days of the month (intervention) or routine, laboratory-based RP PCR testing +/? atypical serology on odd days (control). The primary outcome was length of hospital stay. The secondary outcomes were impact on the use of antimicrobials, readmissions, all-cause mortality, length of ward stay and turn-around time (TAT) (time to result from admission). Results Of 606 eligible patients, 545 (89.9%) were included; 211 in the control arm and 334 in the intervention arm. 20% of control arm patients and 24% of intervention arm patients had an RP detected. POC testing was not associated with the primary outcome measure, length of stay, but reduced the TAT from 39.5?h to 19.0?h, p Conclusions We found no association between respiratory PCR POC testing and length of stay or most of the secondary outcomes except the antimicrobial prescribing decision. This was probably due to a delay in initiating FilmArray? testing. Despite this, POC testing allowed time-critical antivirals to be given significantly faster, appropriate mycoplasma treatment and results were available considerably faster than routine, laboratory-based testing. Ward-staff of all grades performed POC testing without difficulty suggesting potential use across many divergent healthcare settings. Further studies evaluating the implementation of rapid respiratory PCR POC testing and the effect on length of stay and antimicrobial use are required. Trial registration ISRCTN10470967 , Retrospectively Registered, 30/6/2015.
机译：背景技术基于实验室的R espiratory病原体（RP）结果通常为时已晚，以影响由于标本和测试时间表运输的时间延迟而导致住院或抗生素治疗等临床决定。基于病房的i.E.护理点（POC）测试提供快速结果可能会改变临床管理途径。方法Fetmarray吗？ RP聚合酶链反应（PCR）系统置于三个患者和外患者医疗区域。患者用流感样疾病/上呼吸道感染+ /？ 2015年1月至7月之间招募了较低的RTI。电影阵列？ PoC测试在月份（干预）或常规，基于实验室的RP PCR测试+ /？奇数天的非典型血清学（控制）。主要结果是住院住院的长度。二次结果是对使用抗微生物，入伍，全因死亡率，病房留下的长度和转弯时间（TAT）的影响的影响，（参加录取时间）。结果606符合条件的患者，包括545名（89.9％）; 211在控制臂和334中在干预臂中。 20％的控制臂患者和24％的干预臂患者检测到RP。 PoC测试与主要结果措施无关，保持时间长度，但从39.5℃降低到19.0？H，P结论我们发现呼吸PCR PC PCOC测试与住宿长度或大多数次要结果之间没有关联。除了抗微生物处方决策。这可能是由于启动电影阵列的延迟？测试。尽管如此，POC测试允许严重危急的抗病毒毒率明显更快，适当的支原体治疗和结果可比常规，实验室的测试更快。所有等级的病房工作人员都表现出PoC测试，而毫无困难地暗示跨越许多不同的医疗保健设置。进一步的研究进一步研究了快速呼吸PCR PCOC测试的实施以及对保持时间和抗微生物使用的影响。试验登记ISRCTN10470967，回顾性注册，30/6/2015。

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