Performance of a nurse-led paediatric point of care service for respiratory syncytial virus testing in secondary care
Objectives: To evaluate respiratory syncytial virus (RSV)-point-of-care-testing (POCT) performance among paediatric patients with respiratory symptoms, using the BinaxNOW® RSV assay performed by trained nurses on the paediatric ward, and compare results with those obtained by real-time polymerase chain reaction (PCR). Methods: Four paediatric nurses were trained and certified in using RSV-POCT. Between October 2008 and March 2009, all hospitalised children below 5 years of age presenting with a suspected RSV infection had nasopharyngeal swabs (NPS) tested by RSV-POCT by the nurses and a real-time PCR targeting common respiratory viruses by laboratory staff. Results: Among 159 NPS, 21 (13.2%) were RSV-POCT positive and 138 (86.8%) negative. All 21 RSV-POCT positive samples were positive by PCR, yielding a specificity of 100% (95% CI 95.7%, 100.0%). Of 138 RSV-POCT negative samples, 30 (21.7%) were RSV positive by PCR (sensitivity 41.2%; 95% CI: 27.9%, 55.8%). The positive and negative predictive values for RSV-POCT were 100% (95% CI 80.8%, 100.0%) and 78.3% (95% CI 70.3%, 84.6%) respectively. Other respiratory viruses were detected in 52/138 (39.9%) NPS. Conclusions: A POCT for RSV run by trained nurses can be used reliably as a first screening step in symptomatic children. Negative samples should be analysed for RSV and other respiratory pathogens by real-time PCR.
|Keywords||Paediatric, Point of care testing, Real-time RT-PCR, Respiratory syncytial pneumovirus, Respiratory syncytial virus, article, child, child health care, controlled study, diagnostic accuracy, diagnostic test accuracy study, female, human, immunoassay, intermethod comparison, major clinical study, male, nonhuman, nursing competence, pediatric ward, point of care testing, predictive value, preschool child, quality control, real time polymerase chain reaction, reliability, respiratory syncytial virus infection, sensitivity and specificity, virus characterization, virus detection, virus diagnosis, virus load|
|Persistent URL||dx.doi.org/10.1016/j.jinf.2010.11.002, hdl.handle.net/1765/23743|
|Journal||Journal of Infection|
Khanom, A.B, Velvin, C, Hawrami, K, Schutten, M, Patel, M, Holmes, M.V, … Geretti, A.M. (2011). Performance of a nurse-led paediatric point of care service for respiratory syncytial virus testing in secondary care. Journal of Infection, 62(1), 52–58. doi:10.1016/j.jinf.2010.11.002