POINT OF CARE TESTING FOR RESPIRATORY PATHOGENS (Resp ED POCT)
Research type
Research Study
Full title
A CONTROLLED CLINICAL TRIAL INVESTIGATING THE IMPACT OF POINT OF CARE TESTING FOR ‘ATYPICAL’ PNEUMONIA, BORDETELLA PERTUSSIS AND VIRAL PATHOGENS ON PATIENT PATHWAYS, ANTIMICROBIAL CONSUMPTION AND COST-EFFICIENCY.
IRAS ID
162083
Contact name
Zoe Harris
Contact email
Sponsor organisation
King's College Hospital
Research summary
Viral respiratory tract infections place a significant burden on the National Health Service (NHS) with peak activity during the annual influenza epidemic of the winter months. Most cases are managed either by the patient's general practitioner (GP) or in the Emergency Department (ED). GP’s surgeries and EDs, where patients are seen for a short time only, do not have timely access to diagnostic tests for respiratory viruses, and thus the diagnosis is a clinical one and where there is doubt, a proportion of these infections will be managed with unnecessary antibiotics in order to treat potential, undiagnosed bacterial infection. A proportion of all cases will also require hospital admission necessitating respiratory isolation in a neutral or negative pressure side room. In one study, respiratory viruses were found to be responsible for 12.8% of patients with community acquired pneumonia (CAP) admitted to hospital in the UK. If undiagnosed and unisolated in the hospital, there is the potential for cross-transmission and subsequent ward or even hospital outbreaks. As respiratory virus infections can affect staff as well as patients, the extreme consequences of unisolated cases are ward closures, and excess morbidity and mortality.
Mycoplasma pneumoniae and Chlamydophila pneumoniae (atypical pathogens) and Bordetella pertussis ('pertussis' or 'whooping cough') respiratory tract infections are often diagnosed clinically pending laboratory results, which take days. The laboratory tests have poor performance characteristics. Again, patients may be unnecessarily prescribed antibiotics and/or admitted to hospital. Worryingly morbidity and even mortality may occur due to missed diagnoses.Providing a result for the detection of respiratory viruses, Mycoplasma, Chlamydophila and Pertussis in the ED when the patient is first seen, using point of care testing may avoid the issues highlighted,providing a better quality of care, allowing more efficient use of resources and reducing inappropriate antibiotic use and thus the development of resistance.
REC name
London - Westminster Research Ethics Committee
REC reference
14/LO/1703
Date of REC Opinion
17 Nov 2014
REC opinion
Further Information Favourable Opinion