Change In Clinical Management In Immunocompetent Patients With Acute Respiratory Infection In The Emergency Department When Using The FilmArray® Respiratory Panel

SANTOS D; ECHAVARRIA M; RICARTE C; MARCONE D

Congreso; 8 Congreso de Infectología Pediatria; 2017

Management of respiratory infections in theemergency department is usually based in the clinical manifestations withoutknowing the etiological agent. The use of comprehensive highly rapid molecularpanels gives results for respiratory microorganisms in a timely manner. ObjectiveTo determine the clinicalimpact in antimicrobial prescription and complimentary studies when using ahighly rapid and sensitive molecular method ?Respiratory Panel (RP)-FilmArray?versus a conventional diagnostic method.Materials& MethodsPatients with signs/symptoms of acuterespiratory infection (ARI) who attended the Emergency Department at CEMICUniversity Hospital Buenos Aires, Argentina from April 1, to July 26, 2016 wereenrolled.Patients with congenital cardiopathy, geneticdisorders, oncologic disease, HIV, immunocompromised patients or transplantpatients were excluded. Nasopharyngeal samples were tested in the laboratory by FilmArray orImmunofluorescence (IF).RP-FilmArray detects 20 pathogens while IFdetects 6 pathogens. Results were reported to the attending physician by phonewithin 2 hs for FilmArray and 24-48hs for IF.Changes in medical management including anymodification in antibiotic or oseltamivir prescription(administration/discontinuation/avoid) or in complementary studies requiredwere recorded.ResultsA total of 228 patients (101 children and 127 adults) withacute lower respiratory infection were enrolled. RP-FilmArray was used in 150 patientsand IF in 78 patients.Demographic and epidemiological characteristicswere similar in both groups.Change in clinical management was statisticallyhigher in patients with FilmArray diagnosis (43%) versus those tested by IF(13%) (p