British researchers have developed an innovative approach to using a swab test to diagnose flu and other viral infections in patients with respiratory conditions, resulting in shorter courses of antibiotics and shorter hospital stays.
The test was developed by a team at the NIHR Southampton Biomedical Research Center led by Tristan Clark, a University of Southampton associate professor. The findings were published in the journal Lancet Respiratory Medicine under the title “Routine molecular point-of-care testing for respiratory viruses in adults presenting to hospital with acute respiratory illness (ResPOC): a pragmatic, open-label, randomized controlled trial.”
The test assesses swabs on the spot with a portable device. The quick molecular test means the samples don’t need to be sent to a lab. Results can be delivered within an hour, as opposed to the days needed with regular sample processing.
Its speed makes the test ideal for use in emergency rooms or acute care units.
The approach was tested at University Hospital Southampton during the winters of 2015 and 2016. About half of 720 patients with acute respiratory diseases received the new test and half the standard test. The results were passed on to patients’ doctors.
The point-of-care test gained immediate attention when the study started in 2015. That’s because doctors discovered that a sizable percentage of respiratory patients at the hospital were suffering from a strain of influenza that the seasonal flu vaccine wasn’t targeting.
“My vision is that anyone who comes into hospital with an acute respiratory condition will receive this point-of-care test as soon as they come through the hospital door,” Clark said in a news release. “It tells us immediately what virus the person has so, for example, if they have flu, they can be isolated in a side room and given antiviral drugs without delay.”
That’s what happened with patients who received a flu diagnosis through the point-of-care test. Isolated in a side room to prevent their flu from spreading, they received antiviral medication sooner and more frequently than others with flu.
Clark stressed this approach’s potential for tackling antibiotic resistance by reducing unnecessary or ineffective use of medication. A growing number of bacterial strains have become resistant to antibiotics.
“Lung infections in asthma and COPD [chronic obstructive pulmonary disease] patients are a common cause of antibiotic overuse,” Clark said. “Antibiotics are only effective at treating bacterial infections and not infections caused by a virus like the cold or flu viruses, yet they are often given antibiotics ‘just in case,’ when the cause of the infection is not immediately apparent.” Clark said.
“Tests like this, which enable tailored and personalized medicine, have a major role to play in the fight against antibiotic resistance,” Clark concluded.