Clinical impact of rapid molecular detection of respiratory pathogens in patients with acute respiratory infection.

DR. MARCELA ECHAVARRÍA; D. MARCONE; QUERCI M; SEOANE A; YPAS M; CRISTINA VIDELA; O´FARRELL C; S. VIDAURRETA; EKSTROM J; CARBALLAL G

JOURNAL OF CLINICAL VIROLOGY : THE OFFICIAL PUBLICATION OF THE PAN AMERICAN SOCIETY FOR CLINICAL VIROLOGY.

ELSEVIER SCIENCE BV

Lugar: Amsterdam; Año: 2018 vol. 108 p. 90 - 95

1386-6532

BackgroundAcute respiratory infections (ARI) are a leading cause of morbidity and mortality worldwide. There is a need to demonstrate the clinical impact of using the new, rapid and sensitive molecular assays in prospectively designed studies.Objectives To study the impact on medical management of a rapid molecular assay in patients with respiratory infections.Study design A prospective, randomized, non-blinded study was performed in patients presenting to the Emergency Department during two respiratory seasons (2016-2017). Diagnosis was performed by FilmArray Respiratory Panel (FilmArray-RP) or by immunofluorescence assay (IFA). Results A total of 432 patients (156 children and 276 adults) were analyzed. Diagnosis with FilmArray-RP was associated with significant changes in medical management including withholding antibiotic prescriptions (OR:15.52, 95%CI:1.99-120.83 in adults and OR:12.23, 95%CI:1.56- 96.09 in children), and reduction in complementary studies in children (OR:9.64, 95%CI:2.13-43.63) compared to IFA. Decrease in oseltamivir prescriptions was significantly higher in adults in the FilmArray-RP group (p=0.042; OR:1.19, 95%CI:0.51-2.79) compared to adults managed with IFA. Diagnostic yield was significantly higher by FilmArray-RP (81%) than by IFA (31%)(p