6ER-002 A comparative review of the impact of the introduction of on-site molecular testing on the management of adult patients hospitalised with suspected influenza virus infection

Background and importance Hospitalised influenza positive patients should be isolated and prescribed antiviral treatment. During the flu season of 2017–2018, influenza screens were processed off-site. On-site molecular flu testing was introduced prior to the 2018–2019 season. This study investigated its impact on the clinical management of hospitalised adult patients with a high suspicion of influenza virus infection. Aim and objectives This retrospective cohort study investigated the impact of on-site influenza testing on adult inpatients by comparing key clinical parameters over the flu seasons before and after its introduction. Material and methods Data from influenza peaks in January 2018 and January 2019 were used to compare: (i) uptake of influenza testing, using laboratory records; (ii) turnaround times (TATs), recorded using iLab; (iii) infection control isolation data; and (iv) oseltamivir use, as prescribed in inpatient drug kardexes. Results Number of flu tests performed: 2018=47; 2019=73 (55% increase). Median TAT (days): 2018=7.2 (range 4–11); 2019=0.5 (range 0–3). Appropriate isolation of flu positive patients: 2018=36% (8/22); 2019=78.3% (18/23). Flu exposure (bed nights): 2018=48 (48/98, 49%); 2019=12 (12/110, 10%). Flu exposure in coronary care (no isolation facilities) (bed nights): 2018=7 (2 patients); 2019=10 (4 patients). Inappropriate isolation of flu negative patients (bed nights): 2018=41 (results unavailable during treatment); 2019=0. Appropriate oseltamivir use in flu positive patients: 2018=63.6% (14/22); 2019=95.7% (22/23). Oseltamivir use in flu negative patients: 2018=60% (15/25) and median duration=5 days (range 2–7); 2019=28% (14/50) and median duration=1 day (range 1–3 days). Appropriate isolation and oseltamivir use in flu positive patients: 2018=27% (6/22); 2019=74% (17/23). Conclusion and relevance Increased flu screening in 2019 despite a national fall in hospitalised flu cases compared with 2018 suggests that clinicians were more likely to consider influenza when rapid diagnostics were available on-site. On-site testing significantly reduced TAT, having a measurable impact on the appropriateness of isolation and oseltamivir use. The absence of isolation facilities in the coronary care unit represented a significant clinical risk of influenza exposure. References and/or acknowledgements No conflict of interest.