Performance of a nurse-led paediatric point of care service for respiratory syncytial virus testing in secondary care - 02/08/11
Corresponding author. Dept of Virology, Royal Free Hampstead NHS Trust & UCL Medical School, Pond Street, London NW3 2QG, United Kingdom. Tel.: +44 2077940500.Summary |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Respiratory syncytial virus, Point of care testing, Paediatric, Real-time RT-PCR
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Vol 62 - N° 1
P. 52-58 - janvier 2011 Retour au numéro
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