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Abstract

Background: National guidelines recommend isolation and commencing empirical antiviral therapy for suspected influenza in the inpatient setting, however this is not always done in practice. There are many reasons why influenza may be diagnosed late, and in order to minimise potential harm, rapid results are therefore required.

Methods: During the 2018-19 influenza season, we instigated a policy of calling out all new influenza positives during normal working hours. As well as informing clinical teams of results, we also recorded clinical information, including whether the patient was:

* isolated,

* already on antivirals,

* discharged (and if so on what therapy)

Results: In the peak season (January 1st - March 31st 2019), 179 calls to clinical teams were made. The median time from sample collection to reporting was 28 hours and 33 minutes. 44% of patients were not on antivirals at the time of the result, and 28% were not isolated. Based on these numbers, we estimated that 141-235 inpatients may have been exposed to influenza on our wards. 25% of a total of 309 positive influenza samples were from patients who were discharged at the time of the result. 65% of these patients were discharged with antibiotics, 54% with antivirals, and 37% with both antivirals and antibiotics.

Conclusion: Based on our data, and that of other studies, we hypothesise that rapid influenza results would lead to better infection control practices, reduced spread of infection, and improved antimicrobial stewardship. Molecular point-of-care tests have the potential to resolve some of the issues with late influenza diagnosis.

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/content/journal/acmi/10.1099/acmi.fis2019.po0190
2020-02-28
2020-06-04
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