Multiplex PCR implementation as point-of-care testing in a French emergency department

Bouzid, Donia; Lucet, Jean‐Christophe; Duval, Xavier; Houhou‐Fidouh, Nadhira; Casalino, Enrique; Visseaux, Benoît; Choquet, Christophe; Renoux, Maeva; Ing, Vittiaroat; Dupeyrat, Elise; Agbessi, Alexis-Celestin; Postic, Stephanie Antoniol; Verry, Vanessa; Pierrotin, Laure Falque; Colosi, Luisa; Ghazali, Daniel Aiham

doi:10.1016/j.jhin.2020.01.021

Cited by 10 publications

(9 citation statements)

References 7 publications

(19 reference statements)

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“…Moreover, the QIAstat-SARS also offers the possibility of being used in all non-PCR-trained laboratories or as a point-of-care testing where needed and with a rapid turnaround time (approximately 67 min). Point-of-care testing for respiratory viruses using mPCR has been already suggested as improving patient care with quicker and more appropriate clinical decisions (10,11). The benefits on patient triage, isolation management, and assessment of patients around the world are even more obvious and critically important for COVID-19.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the First Rapid Multiplex PCR Commercial Assay for SARS-CoV-2 Detection

et al. 2020

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33In the race to contain SARS-CoV-2, efficient detection and triage of infected patients must 34 rely on rapid and reliable testing. In this work we performed the first evaluation of the 35 QIAstat-Dx Respiratory SARS-CoV-2 Panel (QIAstat-SARS) for SARS-CoV-2 detection. This 36 assay is the first rapid multiplex PCR (mPCR) assay including SARS-CoV-2 detection, and is 37 fully compatible with a non-PCR trained laboratory or point-of-care (POC) testing. 38 This evaluation was performed using 69 primary clinical samples (66 NPS, 1 BAL and 1 39 tracheal aspirate and 1 bronchial aspirate) comparing the SARS-CoV-2 detection with the 40 currently WHO recommended RT-PCR (WHO-PCR) workflow. Additionally, a comparative 41 limit of detection (LoD) assessment was performed between QIAstat-SARS and the WHO-42 PCR using a quantified clinical sample. Compatibility of sample pre-treatment for viral 43 neutralisation or viscous samples with the QIAstat-SARS system were also tested. 44 The QIAstat-Dx Respiratory SARS-CoV-2 Panel demonstrated a comparable sensitivity to the 45 WHO recommended assay with a limit of detection at 1000 copies/mL. The overall percent 46 agreement between QIAstat-Dx SARS and WHO-PCR on 69 clinical samples was 97% with a 47 sensitivity at 100% (40/40) and specificity at 93% (27/29). No cross reaction was 48 encountered for any other respiratory viruses or bacteria included in the panel. 49 The QIAstat-SARS rapid multiplex-PCR panel provides a highly sensitive, robust and accurate 50 assay for rapid detection of SARS-CoV-2. This assay allows rapid decisions even in non-PCR 51 trained laboratory or point-of-care testing, allowing innovative organisation. 52 on June 9, 2020 by guest http://jcm.asm.org/ Downloaded from 65 direct insertion of the NPS into the cartridge without additional manipulation. This 66 innovative design allows to test samples on demand in any laboratory, even not PCR trained, 67 or as a point-of-care (PoC) test with minimal training. The QIAstat-Dx SARS version of the 68 panel adds the detection of the SARS-CoV-2 in a previously unused amplification chamber, 69 thus without any change for sampling, extraction and PCR conditions for other respiratory 70 viruses' detection (4, 5). As for a few other rapid PCR assays available to date, results are 71 provided in about one hour, compared to labour-intensive three to four hours in-laboratory 72 workflow of most in-house PCR assays. The comprehensiveness and versatility of the kit can 73 potentially provide a useful tool, allowing innovative organisation to test patients suspected 74 of COVID-19 rapidly and with discrimination of other respiratory pathogens. This is of 75 on June 9, 2020 by guest http://jcm.asm.org/ Downloaded from Page 4 importance to accelerate isolation management, patient orientation and treatment 76 decisions. 77 Here, we report the first independent validation of this new commercial PCR assay for SARS-78 CoV-2 detection, using clinical samples both in laboratory and in the emergency department 79 as a point-of-care t...

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Section: Resultsmentioning

confidence: 99%

Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the First Rapid Multiplex PCR Commercial Assay for SARS-CoV-2 Detection

et al. 2020

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“…The average LOS of patients was 7 days, in accordance with the previous studies. 14,15,25 The difference of 2 days was chosen by taking into account the two previous studies showing an overall reduction ranging from 0.8 to 1.1 days when comparing mPCR POC testing with classical virology testing in the central laboratory 14,15 and a post hoc analysis showing Point-of-care rapid respiratory mPCR testing JAC a reduction of 2.8 days when providing the result in <1.6 h. 26 Thus, the number of required subjects was 518, with 259 patients per arm. Baseline characteristics within each group were summarized using appropriate descriptive statistics.…”

Section: Discussionmentioning

confidence: 99%

Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial

Bouzid

Casalino

Mullaert

et al. 2021

Journal of Antimicrobial Chemotherapy

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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.

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“…All four hospitals are part of an academic hospital trust and have the same computer system for collecting demographic data and coding ED stays. In this trust, all patients (including homeless and poor individuals) have similar access to the ED and rapid diagnostic tests for infectious diseases [ 29 ] without any socio-economic disparities. Patients were tested in the ED using a rapid multiplex PCR including SARS-CoV-2 detection [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

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

Casalino

Choquet

Bouzid

et al. 2020

IJERPH

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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.

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Multiplex PCR implementation as point-of-care testing in a French emergency department

Cited by 10 publications

References 7 publications

Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the First Rapid Multiplex PCR Commercial Assay for SARS-CoV-2 Detection

Evaluation of the QIAstat-Dx Respiratory SARS-CoV-2 Panel, the First Rapid Multiplex PCR Commercial Assay for SARS-CoV-2 Detection

Added value of rapid respiratory syndromic testing at point of care versus central laboratory testing: a controlled clinical trial

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

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