Implementation of Alere i Influenza A & B point of care test for the diagnosis of influenza in an ED

Study objective: This study aimed to evaluate the impact of implementing rapid point-of-care testing (POCT) with the Alere i Influenza A & B in an emergency department (ED) during an influenza epidemic. Methods: Direct nasal swabs were prospectively collected following the physical examination of patients aged >18 years who presented to the ED of a tertiary hospital in France with influenza-like illness (ILI) symptoms (N = 301) between February 1st and March 31st, 2016, which coincided with an influenza epidemic. Laboratory-based testing (standard of care) was used to obtain a diagnosis in February 2016 (pre-POCT cohort) and positive results were confirmed using polymerase chain reaction. The primary endpoint was patient time in the ED. Results: A total of 169 and 132 patients participated in the pre-POCT phase and POCT phase respectively. A significantly higher proportion of patients received a positive diagnosis in the POCT cohort compared with the pre-POCT cohort (31% versus 5.3%, P < 0.01). Mean time spent in the ED and hospitalization rate were significantly lower in the POCT cohort (6.06 h versus 4.15 h, P = 0.03, and 44.4% versus 9.7%, P = 0.02, respectively). Despite similar rates in the prescription of antibiotics and antiviral therapies, the proportion of patients who were referred for additional tests was significantly lower in the POCT cohort (78.1% versus 62.1%, P = 0.003, and 80.5% versus 63.6%, P = 0.01, respectively). Conclusions: The Alere i Influenza A & B POCT reduced the length of stay in ED, the hospitalization rates, and the number of additional diagnostic tests compared with standard of care testing. (C) 2017 Elsevier Inc. All rights reserved.