1
|
Batty M, Papadakis G, Zhang C, Tran T, Druce J, Lim CK, Williamson DA, Jackson K. Laboratory assessment of a multi-target assay for the rapid detection of viruses causing vesicular diseases. J Clin Virol 2023; 165:105525. [PMID: 37364498 PMCID: PMC10287189 DOI: 10.1016/j.jcv.2023.105525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The recent mpox outbreak has highlighted the need to rapidly diagnose the causative agents of viral vesicular disease to inform treatment and control measures. Common causes of vesicular disease include Monkeypox virus (MPXV), clades I and II, Herpes simplex viruses Type 1 and Type 2 (HSV-1, HSV-2), human herpes virus 6 (HHV-6), Varicella-zoster virus (VZV) and Enteroviruses (EVs). Here, we assessed a syndromic viral vesicular panel for rapid and simultaneous detection of these 7 targets in a single cartridge. OBJECTIVE The aim of this study was to evaluate the QIAStat-Dx ® viral vesicular (VV) panel and compare with laboratory developed tests (LDTs). Limit of detection, inter-run variability, cross-reactivity and specificity were assessed. Positive and negative percent agreement, and correlation between assays was determined using 124 clinical samples from multiple anatomical sites. RESULTS The overall concordance between the QIAstat and LDTs was 96%. Positive percent agreement was 82% for HHV-6, 89% for HSV-1 and 100% for MPXV, HSV-2, EV and VZV. Negative percent agreement was 100% for all targets assessed. There was no cross-reactivity with Vaccinia, Orf, Molluscum contagiosum viruses, and a pooled respiratory panel. CONCLUSION The QIAstat VV multi-target syndromic panel combine ease of use, rapid turnaround, good sensitivity and specificity for enhanced diagnosis, clinical care and public health responses.
Collapse
Affiliation(s)
- Mitchell Batty
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Georgina Papadakis
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Changxu Zhang
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Thomas Tran
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Julian Druce
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Chuan Kok Lim
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Deborah A Williamson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia; Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
| | - Kathy Jackson
- Victorian Infectious Diseases Reference Laboratory, Royal Melbourne Hospital, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia.
| |
Collapse
|
2
|
Rhinoviruses: molecular diversity and clinical characteristics. Int J Infect Dis 2022; 118:144-149. [PMID: 35248716 DOI: 10.1016/j.ijid.2022.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/19/2022] [Accepted: 02/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Rhinoviruses are commonly considered simple "common cold" agents. The link between their molecular epidemiology and patient clinical presentation and outcomes remains unclear in adult populations. MATERIALS/METHODS All nasopharyngeal or bronchoalveolar lavages were screened using multiplex PCR in three Parisian hospitals from January to September 2018. For all detected rhinoviruses, the VP2/VP4 region was subtyped by sequencing. RESULTS The study included 178 human rhinovirus (HRV) positive unique patients. They were primarily male (56%), with a median age of 62.2 [IQR: 46.8-71.4], frequently presenting chronic respiratory diseases (56%) and/or immunosuppression (46%). Of these, 63% were admitted for respiratory distress, including pneumonia for 25%; 95 (53%), 27 (15%), and 56 (32%) were positive for HRV-A, -B, and -C, respectively. HRV-B appeared more associated with immunosuppressive treatments (58% vs. 30% and 36% of patients for HRV-A and -C, respectively, p = 0.038), higher coinfection rates (54% vs. 34% and 23%, p = 0.03), and higher ICU admission rates (35% vs. 17% and 13%, p = 0.048). Conversely, HRV-A was more frequently associated with pneumonia (54% vs. 31% and 11% for HRV-B and -C, respectively, p = 0.01). CONCLUSIONS This study highlights the high proportion of chronic respiratory diseases or immunosuppression among hospitalized patients infected with a rhinovirus.
Collapse
|
3
|
Loubet P, Bouzid D, Debray MP, Visseaux B. Place des virus respiratoires dans les pneumonies aiguës communautaires de l'adulte : quels changements depuis la Covid-19 ? M�DECINE ET MALADIES INFECTIEUSES FORMATION 2022. [PMCID: PMC8815763 DOI: 10.1016/j.mmifmc.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
L’émergence du SARS-CoV-2 a renforcé l'intérêt pour la place des virus respiratoires, dans les pneumonies aiguës communautaires, en mettant en exergue de nombreux points encore mal connus tels que la part des infections asymptomatiques, les interactions entre virus respiratoires et pathogènes non viraux, leurs périodes d'incubation, leur pathogénicité ou encore la durée d'excrétion variable. La présentation clinique et radiologique des pneumonies aiguës communautaires ne permet pas toujours de distinguer l'origine virale de l'origine bactérienne. L'absence de réelle conséquence thérapeutique semble un frein à l'utilisation des PCR multiplex dans la pratique quotidienne. Toutefois, l'amélioration en termes de délai de rendu des résultats et du nombre de pathogènes inclus dans les panels, ainsi que l'accumulation récente de données épidémiologiques et cliniques, devraient aider à rationaliser l'utilisation de ces tests, faciliter l'interprétation de leurs résultats et guider l'utilisation des molécules antivirales en développement.
Collapse
|
4
|
Bouzid D, Casalino E, Mullaert J, Laurent O, Duval X, Lescure FX, Peiffer Smadja N, Tubiana S, Armand Lefèvre L, Descamps D, Fidouh N, Choquet C, Lucet JC, Visseaux B. Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial. J Antimicrob Chemother 2021; 76:iii20-iii27. [PMID: 34555158 PMCID: PMC8460108 DOI: 10.1093/jac/dkab241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Virus-associated respiratory infections are in the spotlight with the emergence of SARS-CoV-2 and the expanding use of multiplex PCR (mPCR). The impact of molecular testing as a point-of-care test (POCT) in the emergency department (ED) is still unclear. Objectives To compare the impact of a syndromic test performed in the ED as a POCT and in the central laboratory on length of stay (LOS), antibiotic use and single-room assignment. Methods From 19 November 2019 to 9 March 2020, adults with acute respiratory illness seeking care in the ED of a large hospital were enrolled, with mPCR performed with a weekly alternation in the ED as a POCT (week A) or in the central laboratory (week B). Results 474 patients were analysed: 275 during A weeks and 199 during B weeks. Patient characteristics were similar. The hospital LOS (median 7 days during week A versus 7 days during week B, P = 0.29), the proportion of patients with ED-LOS <1 day (63% versus 60%, P = 0.57) and ED antibiotic prescription (59% versus 58%, P = 0.92) were not significantly different. Patients in the POCT arm were more frequently assigned a single room when having a positive PCR for influenza, respiratory syncytial virus and metapneumovirus [52/70 (74%) versus 19/38 (50%) in the central testing arm, P = 0.012]. Conclusions Syndromic testing performed in the ED compared with the central laboratory failed to reduce the LOS or antibiotic consumption in patients with acute respiratory illness, but was associated with an increased single-room assignment among patients in whom a significant respiratory pathogen was detected.
Collapse
Affiliation(s)
- Donia Bouzid
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Enrique Casalino
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Jimmy Mullaert
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Department of Epidemiology, Biostatistics and Clinical Research, Bichat-Claude Bernard University Hospital, Paris, France
| | - Odile Laurent
- AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Xavier Duval
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Department of Epidemiology, Biostatistics and Clinical Research, Bichat-Claude Bernard University Hospital, Paris, France
| | - François Xavier Lescure
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Infectious Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Nathan Peiffer Smadja
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Infectious Diseases Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Sarah Tubiana
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Department of Epidemiology, Biostatistics and Clinical Research, Bichat-Claude Bernard University Hospital, Paris, France
| | - Laurence Armand Lefèvre
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Bacteriology, Bichat-Claude Bernard University Hospital, Paris, France
| | - Diane Descamps
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Nadhira Fidouh
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Christophe Choquet
- AP-HP Nord, Emergency Department, Bichat-Claude Bernard University Hospital, Paris, France
| | - Jean-Christophe Lucet
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Infection Control Unit, Bichat-Claude Bernard University Hospital, Paris, France
| | - Benoit Visseaux
- Université de Paris, INSERM, IAME, F-75006 Paris, France.,AP-HP Nord, Virology Department, Bichat-Claude Bernard University Hospital, Paris, France
| |
Collapse
|
5
|
Lebourgeois S, Storto A, Gout B, Le Hingrat Q, Ardila Tjader G, Cerdan MDC, English A, Pareja J, Love J, Houhou-Fidouh N, Manissero D, Descamps D, Visseaux B. Performance evaluation of the QIAstat-Dx® Respiratory SARS-CoV-2 Panel. Int J Infect Dis 2021; 107:179-181. [PMID: 33901651 PMCID: PMC8064816 DOI: 10.1016/j.ijid.2021.04.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/20/2021] [Accepted: 04/20/2021] [Indexed: 12/05/2022] Open
Abstract
Objective The aim of this study was to evaluate the QIAstat-Dx® Respiratory SARS-CoV-2 Panel (QIAstat-SARS-CoV-2), which is a closed, fully automated, multiplex polymerase chain reaction (PCR) assay that detects severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 21 other pathogens that cause respiratory disease. Methods Nasopharyngeal swabs from patients with or suspected of having coronavirus disease 2019 were collected and tested at Bichat–Claude Bernard Hospital, Paris, France. Using the World Health Organisation-approved real-time-PCR assay developed by the Charité Institute of Virology as the reference, positive percent agreement (PPA) and negative percent agreement (NPA) were calculated. Results In total, 189 negative and 88 positive samples were analyzed. QIAstat-SARS-CoV-2 had an NPA of 90.48% (95% confidence interval (CI), 85.37%, 94.26%) and a PPA of 94.32% (95% CI, 87.24%, 98.13%). Co-infections were detected by QIAstat-SARS-CoV-2 in 4/277 specimens. The methods exhibited comparable failure rates (23/307 [7.5%] vs. 6/298 [2.0%] for QIAstat-SARS-CoV-2 and reference methods, respectively). The turnaround time was shorter for QIAstat-SARS-CoV-2 compared with the reference method (difference in mean –14:30 h [standard error, 0:03:23; 95% CI, –14:37, –14:24]; P < 0.001). Conclusions QIAstat-SARS-CoV-2 shows good agreement with the reference assay, providing faster and accurate results for detecting SARS-CoV-2.
Collapse
Affiliation(s)
- Samuel Lebourgeois
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France; Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
| | - Alexandre Storto
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France; Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
| | - Bernard Gout
- ARC Regulatory Ltd., Moneymore, Magherafelt, Northern Ireland, UK
| | - Quentin Le Hingrat
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France; Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
| | - Gustave Ardila Tjader
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
| | | | | | - Josep Pareja
- STAT-Dx Life, S.L. (a QIAGEN Company), Barcelona, Spain
| | - Joanna Love
- STAT-Dx Life, S.L. (a QIAGEN Company), Barcelona, Spain
| | - Nadhira Houhou-Fidouh
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
| | | | - Diane Descamps
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France; Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
| | - Benoit Visseaux
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France; Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France.
| |
Collapse
|
6
|
Harris C, Harris RJ, Downey L, Gwiggner M. Management of Crohn's disease in an immunosuppressed COVID-19-positive patient: safety-driven prioritisation of nutritional therapy as a bridge to restarting immunosuppression. BMJ Case Rep 2021; 14:e239404. [PMID: 33753379 PMCID: PMC7986758 DOI: 10.1136/bcr-2020-239404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 01/08/2023] Open
Abstract
Active inflammatory bowel disease (IBD), combined immunosuppression and corticosteroid therapy have all been identified as risk factors for a poor outcome in COVID-19 infection. The management of patients with both COVID-19 infection and active IBD is therefore complex. We present the case of a 31-year-old patient with Crohn's disease, on dual immunosuppression with infliximab and mercaptopurine presenting with inflammatory small bowel obstruction and COVID-19 infection. The case highlights the use of nutritional therapy, which remains underused in the management of adults with IBD, to manage his flare acutely. Following negative SARS-CoV-2 PCR testing and SARS-CoV-2 IgG testing confirming an antibody response, ustekinumab (anti-interleukin 12/23) was prescribed for long-term maintenance.
Collapse
Affiliation(s)
- Clare Harris
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Richard James Harris
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Louise Downey
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Markus Gwiggner
- Department of Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| |
Collapse
|
7
|
|
8
|
Casalino E, Choquet C, Bouzid D, Peyrony O, Curac S, Revue E, Fontaine JP, Plaisance P, Chauvin A, Ghazali DA. Analysis of Emergency Department Visits and Hospital Activity during Influenza Season, COVID-19 Epidemic, and Lockdown Periods in View of Managing a Future Disaster Risk: A Multicenter Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8302. [PMID: 33182696 PMCID: PMC7698314 DOI: 10.3390/ijerph17228302] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 12/14/2022]
Abstract
ED-visits and through-ED admissions to medical/surgical wards (MSW) and intensive care unit (ICU) during influenza, COVID-19 and lockdown periods were evaluated in a four-hospital prospective observational study from November 2018 to March 2020. ED visit characteristics and main diagnostic categories were assessed. Analysis of 368,262 ED-visits highlighted a significantly increasing trend in ED-visits during influenza followed by a significantly decreasing trend after lockdown. For MSW-admissions, a pattern of growth during influenza was followed by a fall that began during COVID-19 pandemic and intensified during the lockdown. For ICU-admissions, a significant rise during the COVID-19 pandemic was followed by diminution during the lockdown period. During lockdown, significantly diminishing trends were shown for all diagnostic categories (between -40.8% and -73.6%), except influenza-like illness/COVID cases (+31.6%), Pulmonary embolism/deep vein thrombosis (+33.5%) and frequent users (+188.0%). The present study confirms an increase in demand during the influenza epidemic and during the initial phase of the COVID-19 epidemic, but a drop in activity during the lockdown, mainly related to non-COVID conditions. Syndromic surveillance of ILI cases in ED is a tool for monitoring influenza and COVID-19, and it can predict ED activity and the need for MSW and ICU beds.
Collapse
Affiliation(s)
- Enrique Casalino
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018 Paris, France; (E.C.); (C.C.); (D.B.)
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- IAME (Infection, Antimicrobial, Modeling, Evaluation), INSERM UMR1137, Université de Paris, 75018 Paris, France
| | - Christophe Choquet
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018 Paris, France; (E.C.); (C.C.); (D.B.)
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
| | - Donia Bouzid
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018 Paris, France; (E.C.); (C.C.); (D.B.)
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- IAME (Infection, Antimicrobial, Modeling, Evaluation), INSERM UMR1137, Université de Paris, 75018 Paris, France
| | - Olivier Peyrony
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Saint Louis, 75010 Paris, France
| | - Sonja Curac
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, 92110 Clichy, France
| | - Eric Revue
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 75010 Paris, France
| | - Jean-Paul Fontaine
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Saint Louis, 75010 Paris, France
| | - Patrick Plaisance
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 75010 Paris, France
| | - Anthony Chauvin
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, 75010 Paris, France
- Centre of Research in Epidemiology and Statistics, INSERM UMR1153, Université Sorbonne, 75004 Paris, France
| | - Daniel Aiham Ghazali
- Emergency Department, Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, 75018 Paris, France; (E.C.); (C.C.); (D.B.)
- Study Group for Efficiency and Quality of Emergency Departments and Non-Scheduled Activities Departments, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; (O.P.); (S.C.); (E.R.); (J.-P.F.); (P.P.); (A.C.)
- IAME (Infection, Antimicrobial, Modeling, Evaluation), INSERM UMR1137, Université de Paris, 75018 Paris, France
- Emergency Medical Services, Assistance Publique-Hôpitaux de Paris, Hôpital Beaujon, 92110 Clichy, France
| |
Collapse
|
9
|
Bouzid D, Visseaux B, Perozziello A, Lescure X, Duval X, Casalino E, Lucet JC. Factors associated with single-room assignment among patients admitted through the emergency department during influenza epidemics. PLoS One 2020; 15:e0237214. [PMID: 32764788 PMCID: PMC7413401 DOI: 10.1371/journal.pone.0237214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/22/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Every winter, emergency departments (EDs) face overcrowding with patients presenting influenza-like symptoms, and organisational issues such as single room assignment and droplet precautions to avoid hospital-acquired influenza. Our main objective was to assess the impact of PCR results and patient's severity on single room assignment. METHODS All patients admitted to Bichat-Claude Bernard Hospital through the ED and tested for influenza by PCR (GenXpert, Cepheid) or (FilmArray, BioMérieux) on a nasopharyngeal swab were retrospectively included during three influenza seasons (2015-2018. RESULTS Of 1,330 included patients, 278 (20.9%) had a positive PCR for influenza. The median time to obtain a PCR result was 19 hours, and 238 (18.3%) patients were assigned a single room. Among patients with positive and negative influenza PCR, 22.3% and 16.7% were assigned a single room (p = 0.03). The multivariable analysis was performed on the two first epidemic periods, excluding the third epidemic because of the concomitant use of influenza immune-chromatic test. Only level 1 of the Emergency severity index (ESI) (aOR, 1.9; 95% CI, 1.3-2.8; p < 0.01) was associated with single-room assignment. PCR result was not statistically associated with the decision of single room assignment (aOR, 1.4; 95%CI, 1.0-1.4; p = 0.07). CONCLUSION A PCR positive for influenza was not significantly associated with single-room assignment. Less than one quarter of influenza patients were adequately assigned a single room, likely due to the long turnaround time of PCR result and other conflicting indications for single room-assignment. Accelerating biological diagnosis could improve single-room assignment.
Collapse
Affiliation(s)
- Donia Bouzid
- IAME, INSERM, Université de Paris, Paris, France
- Emergency Department, AP-HP, University Hospital Bichat-Claude Bernard, Paris, France
| | - Benoit Visseaux
- IAME, INSERM, Université de Paris, Paris, France
- AP-HP, University Hospital Bichat-Claude Bernard, Virology, Paris, France
| | | | - Xavier Lescure
- IAME, INSERM, Université de Paris, Paris, France
- Infectious Disease Department, AP-HP, University Hospital Bichat-Claude Bernard, Paris, France
- Clinical Investigation Center, AP-HP, University Hospital Bichat-Claude Bernard, Paris, France
| | - Xavier Duval
- IAME, INSERM, Université de Paris, Paris, France
- Infection Control Unit, AP-HP, University Hospital Bichat-Claude, Paris, France
| | - Enrique Casalino
- IAME, INSERM, Université de Paris, Paris, France
- Emergency Department, AP-HP, University Hospital Bichat-Claude Bernard, Paris, France
| | - Jean Christophe Lucet
- IAME, INSERM, Université de Paris, Paris, France
- Infection Control Unit, AP-HP, University Hospital Bichat-Claude, Paris, France
| | | |
Collapse
|
10
|
Visseaux B, Le Hingrat Q, Collin G, Bouzid D, Lebourgeois S, Le Pluart D, Deconinck L, Lescure FX, Lucet JC, Bouadma L, Timsit JF, Descamps D, Yazdanpanah Y, Casalino E, Houhou-Fidouh N. Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the First Rapid Multiplex PCR Commercial Assay for SARS-CoV-2 Detection. J Clin Microbiol 2020; 58:e00630-20. [PMID: 32341142 PMCID: PMC7383528 DOI: 10.1128/jcm.00630-20] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/23/2020] [Indexed: 01/22/2023] Open
Abstract
In the race to contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), efficient detection and triage of infected patients must rely on rapid and reliable testing. In this work, we performed the first evaluation of the QIAstat-Dx respiratory SARS-CoV-2 panel (QIAstat-SARS) for SARS-CoV-2 detection. This assay is the first rapid multiplex PCR (mPCR) assay, including SARS-CoV-2 detection, and is fully compatible with a non-PCR-trained laboratory or point-of-care (PoC) testing. This evaluation was performed using 69 primary clinical samples (66 nasopharyngeal swabs [NPS], 1 bronchoalveolar lavage fluid sample [BAL], 1 tracheal aspirate sample, and 1 bronchial aspirate sample) comparing SARS-CoV-2 detection with the currently WHO-recommended reverse transcription-PCR (RT-PCR) (WHO-RT-PCR) workflow. Additionally, a comparative limit of detection (LoD) assessment was performed for QIAstat-SARS and WHO-RT-PCR using a quantified clinical sample. Compatibility of sample pretreatment for viral neutralization or viscous samples with the QIAstat-SARS system were also tested. The QIAstat-Dx respiratory SARS-CoV-2 panel demonstrated a sensitivity comparable to that of the WHO-recommended assay with a limit of detection at 1,000 copies/ml. The overall percent agreement between QIAstat-Dx SARS and WHO-RT-PCR on 69 clinical samples was 97% with a sensitivity of 100% (40/40) and specificity at 93% (27/29). No cross-reaction was encountered for any other respiratory viruses or bacteria included in the panel. The QIAstat-SARS rapid multiplex PCR panel provides a highly sensitive, robust, and accurate assay for rapid detection of SARS-CoV-2. This assay allows rapid decisions even in non-PCR-trained laboratory or point-of-care testing, allowing innovative organization.
Collapse
Affiliation(s)
- Benoit Visseaux
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Quentin Le Hingrat
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Gilles Collin
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Donia Bouzid
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service d'Accueil des Urgences, Hôpital Bichat, Paris, France
| | - Samuel Lebourgeois
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Diane Le Pluart
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Laurène Deconinck
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - François-Xavier Lescure
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-Christophe Lucet
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Unité d'Hygiène et de Lutte contre les Infections Nosocomiales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Lila Bouadma
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Jean-François Timsit
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Réanimation Médicale et Infectieuse, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Diane Descamps
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service de Virologie, Hôpital Bichat, Paris, France
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
| | - Yazdan Yazdanpanah
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Enrique Casalino
- UMR 1137-IAME, Decision Sciences in Infectious Diseases Control and Care (DeSCID), INSERM, Université de Paris, Paris, France
- Université de Paris, Assistance Publique - Hôpitaux de Paris, Service d'Accueil des Urgences, Hôpital Bichat, Paris, France
| | | |
Collapse
|