IDWEEK 2015 ORAL ABSTRACTS 102. Clinical Utility of Rapid Molecular-Based Influenza Testing Andrea Dugas, MD, PhD1; Richard Rothman, MD, PhD2; 1Emergency Medicine, Johns Hopkins University, Baltimore, Maryland; 2Johns Hopkins Medical Institute, Baltimore, Maryland Session: 36. Diagnostics: Typing/Sequencing Thursday, October 8, 2015: 10:30 AM Background. Diagnosing influenza in the emergency department (ED) remains a challenge because clinicians have not had, until recently, reliable tests to accurately and rapidly diagnose influenza; however, rapid diagnosis is crucial to begin antiviral therapy in patients with, or at risk of influenza-related complications, as recommended by the Centers for Disease Control and Prevention (CDC). A new generation of rapid molecular-based tests, including Xpert Flu (Cepheid), have recently demonstrated high sensitivity (95%) and specificity (99%), allowing for timely and accurate influenza diagnosis and improved use of antivirals in the ED. We sought to evaluate the impact
of rapid molecular-based influenza testing on clinician decision-making for antiviral administration in ED patients with, or at increased risk for, influenza-related complications. Methods. We performed a multicenter prospective controlled trial at 4 US EDs. From November 2013 to April 2014, we enrolled adults who presented to the ED with an acute respiratory illness who would meet CDC criteria for antiviral treatment if influenza positive. The test sites (2 EDs) performed Xpert Flu testing on all enrolled participants, and the result was given to the ED provider. The control sites (2 EDs) continued usual care with provider-directed influenza testing using either rapid antigen tests or traditional polymerase chain reaction (PCR). All subjects received influenza testing with gold-standard PCR; however, this result was not given to the clinical team. Using gold-standard PCR to define influenza status, we compared antiviral treatment rates between the test sites and the control sites in both influenza-positive and -negative subjects using a χ2 test. Results. Of 1987 enrolled subjects, 185 (9.3%) had influenza. Amongst influenza-positive subjects, the test sites had significantly higher rates of antiviral treatment (61, 72%) compared with the control sites (23, 21%) (P < .001). The test group also had higher rates of antiviral treatment (41, 4.4%) in influenza-negative subjects compared with the control group (8, 1.0%) (P < .001). Conclusion. Integrating highly sensitive molecular-based influenza testing into ED practice impacts antiviral treatment and increases adherence with CDC antiviral treatment guidelines. Disclosures. All authors: No reported disclosures.
Open Forum Infectious Diseases 2015;2:1–66 © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [email protected]. DOI: 10.1093/ofid/ofv131
Oral Abstracts
•
OFID 2015:2 (Suppl 1)
•
S1
of rapid molecular-based influenza testing on clinician decision-making for antiviral administration in ED patients with, or at increased risk for, influenza-related complications. Methods. We performed a multicenter prospective controlled trial at 4 US EDs. From November 2013 to April 2014, we enrolled adults who presented to the ED with an acute respiratory illness who would meet CDC criteria for antiviral treatment if influenza positive. The test sites (2 EDs) performed Xpert Flu testing on all enrolled participants, and the result was given to the ED provider. The control sites (2 EDs) continued usual care with provider-directed influenza testing using either rapid antigen tests or traditional polymerase chain reaction (PCR). All subjects received influenza testing with gold-standard PCR; however, this result was not given to the clinical team. Using gold-standard PCR to define influenza status, we compared antiviral treatment rates between the test sites and the control sites in both influenza-positive and -negative subjects using a χ2 test. Results. Of 1987 enrolled subjects, 185 (9.3%) had influenza. Amongst influenza-positive subjects, the test sites had significantly higher rates of antiviral treatment (61, 72%) compared with the control sites (23, 21%) (P < .001). The test group also had higher rates of antiviral treatment (41, 4.4%) in influenza-negative subjects compared with the control group (8, 1.0%) (P < .001). Conclusion. Integrating highly sensitive molecular-based influenza testing into ED practice impacts antiviral treatment and increases adherence with CDC antiviral treatment guidelines. Disclosures. All authors: No reported disclosures.
Open Forum Infectious Diseases 2015;2:1–66 © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [email protected]. DOI: 10.1093/ofid/ofv131
Oral Abstracts
•
OFID 2015:2 (Suppl 1)
•
S1
