Skip to main content
Top
Published in: European Journal of Clinical Microbiology & Infectious Diseases 1/2021

01-01-2021 | Respiratory Syncytial Virus Infection | Original Article

Factors affecting the discharge of patients from hospital with seasonal influenza—the role of the Rapid Influenza testing in hospital discharges

Authors: Ruchir Chavada, Liam Clifford, Owen Weisback

Published in: European Journal of Clinical Microbiology & Infectious Diseases | Issue 1/2021

Login to get access

Abstract

Influenza is a major cause of presentations to the emergency departments. Introduction of the Rapid Influenza tests has assisted with diagnosis and facilitated patient discharges. We designed this study to identify factors affecting hospital discharge and to understand the role of Rapid Influenza testing. A retrospective observational study of patients was done during influenza season in 2017. Clinical data was obtained from electronic medical records. Rapid Influenza testing was performed using Xpert Flu/RSV (Cepheid, USA). Univariate and multivariate analysis was done using SPSS Version 26 (IBM, NY). A total of 665 patients presented with laboratory-confirmed influenza. Patients discharged from the hospital were younger (median age 62 vs 68, p = 0.031). Patients with immunosuppression, chronic obstructive pulmonary disease (COPD) and pneumonia were more likely to be admitted to hospital. Rapid testing done with a turnaround (TAT) of 2 h (27.8% vs 17.8%, p = 0.002) and with a TAT of 6 h (55% vs 46.3%, p = 0.026) of the patient presentation was associated with a higher rate of hospital discharge. Median TAT of the RIT was 6 h (IQR 1–40 h). On multivariable analysis, RIT TAT of ≤ 2 h (OR 1.62, p = 0.013) was associated with higher likelihood of patients being discharged, whereas immunosuppressed patients (OR 2.25, p = 0.011), COPD (OR 2.42, p = 0.001) and pneumonia on presentation (OR 8.10, p < 0.001) were more likely to get admitted. Patients with COPD, pneumonia on presentation and those with immunosuppression are more likely to be admitted. Rapid Influenza tests can facilitate the discharge of patients from hospital.
Literature
2.
go back to reference Akers E, Weber R, Sax H, Böni J et al (2017) Influence of time to diagnosis of severe influenza on antibiotic use, length of stay, isolation precautions, and mortality: a retrospective study. Influenza Other Respir Viruses 11(4):337–344CrossRef Akers E, Weber R, Sax H, Böni J et al (2017) Influence of time to diagnosis of severe influenza on antibiotic use, length of stay, isolation precautions, and mortality: a retrospective study. Influenza Other Respir Viruses 11(4):337–344CrossRef
4.
go back to reference Nielsen J, Vestergaard LS, Richter L, Schmid D et al ( 2019) European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered? Clin Microbiol Infect, 25: 1266 - 1276 Nielsen J, Vestergaard LS, Richter L, Schmid D et al ( 2019) European all-cause excess and influenza-attributable mortality in the 2017/18 season: should the burden of influenza B be reconsidered? Clin Microbiol Infect, 25: 1266 - 1276
5.
go back to reference Rogers BB, Shankar P, Jerris RC et al (2015) Impact of a rapid respiratory panel test on patient outcomes. Arch Pathol Lab Med 139:636–641CrossRef Rogers BB, Shankar P, Jerris RC et al (2015) Impact of a rapid respiratory panel test on patient outcomes. Arch Pathol Lab Med 139:636–641CrossRef
6.
go back to reference Kakeya H, Seki M, Izumikawa K et al (2014) Efficacy of combination therapy with oseltamivir phosphate and azithromycin for influenza: a multicenter, open-label, randomized study. PLoS One 9:e91293CrossRef Kakeya H, Seki M, Izumikawa K et al (2014) Efficacy of combination therapy with oseltamivir phosphate and azithromycin for influenza: a multicenter, open-label, randomized study. PLoS One 9:e91293CrossRef
7.
go back to reference Shiley KT, Lautenbach E, Lee I (2010) The use of antimicrobial agents after diagnosis of viral respiratory tract infections in hospitalized adults: antibiotics or anxiolytics? Infect Control Hosp Epidemiol 31:1177–1183CrossRef Shiley KT, Lautenbach E, Lee I (2010) The use of antimicrobial agents after diagnosis of viral respiratory tract infections in hospitalized adults: antibiotics or anxiolytics? Infect Control Hosp Epidemiol 31:1177–1183CrossRef
8.
go back to reference Oosterheert JJ, van Loon AM, Schuurman R et al (2005) Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clin Infect Dis 41:1438–1444CrossRef Oosterheert JJ, van Loon AM, Schuurman R et al (2005) Impact of rapid detection of viral and atypical bacterial pathogens by real-time polymerase chain reaction for patients with lower respiratory tract infection. Clin Infect Dis 41:1438–1444CrossRef
9.
go back to reference van Esso DL, Valente AM, Vilà M, Casanovas JM et al (2019) Rapid Influenza testing in infants and children younger than 6 years in primary care: impact on antibiotic treatment and use of health services. Pediatr Infect Dis J 38(8):e187–e189CrossRef van Esso DL, Valente AM, Vilà M, Casanovas JM et al (2019) Rapid Influenza testing in infants and children younger than 6 years in primary care: impact on antibiotic treatment and use of health services. Pediatr Infect Dis J 38(8):e187–e189CrossRef
10.
go back to reference Garvey MI, Wilkinson MAC, Bradley CW, Biggs M et al (2019) Impact of a PCR point of care test for influenza A/B on an acute medical unit in a large UK teaching hospital: results of an observational, pre and post intervention study. Antimicrob Resist Infect Control 8:120CrossRef Garvey MI, Wilkinson MAC, Bradley CW, Biggs M et al (2019) Impact of a PCR point of care test for influenza A/B on an acute medical unit in a large UK teaching hospital: results of an observational, pre and post intervention study. Antimicrob Resist Infect Control 8:120CrossRef
11.
go back to reference Valentin T, Kieslinger P, Stelzl E, Santner BI et al (2019) Prospective evaluation of three rapid molecular tests for seasonal influenza in patients presenting at an emergency unit. J Clin Virol 111:29–32CrossRef Valentin T, Kieslinger P, Stelzl E, Santner BI et al (2019) Prospective evaluation of three rapid molecular tests for seasonal influenza in patients presenting at an emergency unit. J Clin Virol 111:29–32CrossRef
14.
go back to reference Rappo U, Schuetz A, Jenkins S et al (2016) Impact of early detection of respiratory viruses by multiplex PCR assay on clinical outcomes in adult patients. J Clin Microbiol 54:2096–2103CrossRef Rappo U, Schuetz A, Jenkins S et al (2016) Impact of early detection of respiratory viruses by multiplex PCR assay on clinical outcomes in adult patients. J Clin Microbiol 54:2096–2103CrossRef
15.
go back to reference Linehan E, Brennan M, O’Rourke S et al (2018) Impact of introduction of Xpert Flu assay for Influenza PCR testing on obstetric patients: a quality improvement project. J Matern Fetal Neonatal Med 31:1016–1020CrossRef Linehan E, Brennan M, O’Rourke S et al (2018) Impact of introduction of Xpert Flu assay for Influenza PCR testing on obstetric patients: a quality improvement project. J Matern Fetal Neonatal Med 31:1016–1020CrossRef
20.
go back to reference Garvey MI, Wilkinson MAC, Bradley CW, Biggs M et al (2019) Impact of a PCR point of care test for influenza A/B on an acute medical unit in a large UK teaching hospital: results of an observational, pre and post intervention study. Antimicrob Resist Infect Control. https://doi.org/10.1186/s13756-019-0575-6 Garvey MI, Wilkinson MAC, Bradley CW, Biggs M et al (2019) Impact of a PCR point of care test for influenza A/B on an acute medical unit in a large UK teaching hospital: results of an observational, pre and post intervention study. Antimicrob Resist Infect Control. https://​doi.​org/​10.​1186/​s13756-019-0575-6
21.
go back to reference O’Callaghan K, Jones K (2019) Rapid testing for respiratory viruses: impact on antibiotic use and time to patient discharge. Infect Dis Health 24(3):147–151CrossRef O’Callaghan K, Jones K (2019) Rapid testing for respiratory viruses: impact on antibiotic use and time to patient discharge. Infect Dis Health 24(3):147–151CrossRef
22.
go back to reference Yandrapalli S, Aronow W, Frishman W (2018) Readmissions in adult patients following hospitalisation for influenza: a nationwide cohort study. Ann Transl Med 6(16):318CrossRef Yandrapalli S, Aronow W, Frishman W (2018) Readmissions in adult patients following hospitalisation for influenza: a nationwide cohort study. Ann Transl Med 6(16):318CrossRef
24.
go back to reference Li-Kim-Moy J, Yin K, Blyth C, Kesson A et al (2017) Influenza hospitalisations in Australian children. Epidemiol Infect 145(7):1451–1460CrossRef Li-Kim-Moy J, Yin K, Blyth C, Kesson A et al (2017) Influenza hospitalisations in Australian children. Epidemiol Infect 145(7):1451–1460CrossRef
25.
go back to reference Wabe N, Li L, Dahm MR, Lindeman R, Yimsung R et al (2019) Timing of respiratory virus molecular testing in emergency departments and its association with patient care outcomes: a retrospective observational study across six Australian hospitals. BMJ Open 9(8):e030104CrossRef Wabe N, Li L, Dahm MR, Lindeman R, Yimsung R et al (2019) Timing of respiratory virus molecular testing in emergency departments and its association with patient care outcomes: a retrospective observational study across six Australian hospitals. BMJ Open 9(8):e030104CrossRef
26.
go back to reference Trabattoni E, Le V, Pilmis B, Pean de Ponfilly G (2018) Implementation of Alere i Influenza A & B point of care test for the diagnosis of influenza in an ED. Am J Emerg Med 36(6):916–921CrossRef Trabattoni E, Le V, Pilmis B, Pean de Ponfilly G (2018) Implementation of Alere i Influenza A & B point of care test for the diagnosis of influenza in an ED. Am J Emerg Med 36(6):916–921CrossRef
27.
go back to reference Youngs J, Marshall B, Farragher M, Whitney L et al (2019) Implementation of influenza point-of-care testing and patient cohorting during a high-incidence season: a retrospective analysis of the impact on infection prevention and control and clinical outcomes. J Hosp Infect 101(3):276–284CrossRef Youngs J, Marshall B, Farragher M, Whitney L et al (2019) Implementation of influenza point-of-care testing and patient cohorting during a high-incidence season: a retrospective analysis of the impact on infection prevention and control and clinical outcomes. J Hosp Infect 101(3):276–284CrossRef
Metadata
Title
Factors affecting the discharge of patients from hospital with seasonal influenza—the role of the Rapid Influenza testing in hospital discharges
Authors
Ruchir Chavada
Liam Clifford
Owen Weisback
Publication date
01-01-2021
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Clinical Microbiology & Infectious Diseases / Issue 1/2021
Print ISSN: 0934-9723
Electronic ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-019-03752-3

Other articles of this Issue 1/2021

European Journal of Clinical Microbiology & Infectious Diseases 1/2021 Go to the issue