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

Andrews, Denise; Chetty, Yumela; Cooper, Ben S.; Virk, Manjinder; Glass, Stephen K; Letters, Andrew; Kelly, Philip A.; Sudhanva, Malur; Jeyaratnam, Dakshika

POC testing was associated with a reduction in time to antivirals for those identified with influenza virus. Antivirals were given a day and a half quicker in the intervention arm and within a day of admission. Given that these drugs are of clinical benefit only if administered within 48 h of symptom onset [4] , this is a key, clinical outcome. POC testing allowed changes to therapy for the appropriate treatment of mycoplasma infection; in the control arm, positive results were uninterpretable and were predominantly available after discharge. The ability of FilmArray® to detect coronaviruses allowed for a diagnosis to be made in 15 samples that would have been missed using routine methods. Routine testing only identified single pathogens as opposed to FilmArray® which identified dual infection in 5 patients, of importance for infection control and virus surveillance. Parainfluenza virus types 1, 2 and 4, Chlamydia pneumoniae and Bordetella pertussis were not detected during the course of this study which did not span the entire winter.