The Importance of Rapid Influenza Testing in Pediatric Primary Care: Experience During Three Consecutive Influenza Seasons (2016–2019) in Barcelona (Catalonia, Spain)

Frontiers in Pediatrics

article

Diego van Esso¹  Mar Pérez¹  Mª Angeles Ferrandez¹  Esther Hernando¹  Carlos Rodrigo²  Tomàs Pumarola⁴  Andrés Antón⁴  Monica Vil๠ Cristina Andrés⁴  Sheila Iglesias¹  Josep Ferrer¹  Lucia Losada¹  Gemma Ricos¹  Lorena Sanchez¹  Patricia Morera¹ 

[1] Primary Care Health Service SAP Muntanya, Catalan Institute of Health;Department of Paediatrics, Vall d'Hebron University Hospital;School of Medicine Germans Trias i Pujol University Hospital, Autonomous University of Barcelona;Respiratory Virus Unit, Microbiology Department, Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Autonomous University of Barcelona

关键词: influenza;    primary care;    children;    rapid influenza diagnostic test (RIDT);    point of care test (POCT);    pediatrics;    respiratory viral infection;   

DOI  :  10.3389/fped.2020.00565

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Clinical diagnosis of influenza has low sensitivity in infants and children. Signs and symptoms are non-specific and similar to those of other respiratory viruses. Rapid influenza diagnostic tests (RIDTs) with adequate sensitivity and specificity used at the point of care can be useful for an etiologic diagnosis of influenza in primary care. This should have an impact on better management of these patients. We conducted a study during three consecutive influenza seasons (2016–2017, 2017–2018, and 2018–2019) in pediatric primary care settings collecting data from influenza point-of-care tests (POCTs)-confirmed ≤ 6-year-old patients. During the first two influenza seasons, antibiotic prescriptions and additional visits from influenza POCT-confirmed patients (Group_1) were compared to patients with influenza-like illness (ILI) (Group_2), or fever (2016 ICD-10 code R50) with no other signs of influenza (Group_3). Group_1 had 0.19 (2016–2017) and 0.23 (2017–2018) additional visits compared to 0.48 (2016–2017) and 0.49 (2017–2018) Group_2 p < 0.001 and 1.01 (2016–2017) and 0.80 (2017–2018) Group_3 p < 0.001. Antibiotic prescription was lower in Group_1 (10.2%) vs. Group_3 (17.2%) p < 0.002, difference statistically significant only for the 2017–2018 season. During the third season (2018–2019), RIDTs results were transmitted in real time to the reference laboratory ia the cloud, which strengthens the monitoring of circulating influenza viruses in the community. In our experience, the use of POCTs has a great potential in primary care specially in infants and young children in which the diagnosis maybe missed due to non-specific signs and symptoms.

【 授权许可】

CC BY