Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis
Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis
Objectives: the clinical impact of rapid sample-to-answer ‘syndromic’ multiplex polymerase chain reaction (PCR) testing for respiratory viruses is not clearly established. We performed a systematic literature review and meta-analysis to evaluate this impact for patients with possible acute respiratory tract infection in the hospital setting.
Methods: we searched EMBASE, MEDLINE, and Cochrane databases from 2012 to present and conference proceedings from 2021 for studies comparing clinical impact outcomes between multiplex PCR testing and standard testing.
Results: twenty-seven studies with 17,321 patient encounters were included in this review. Rapid multiplex PCR testing was associated with a reduction of -24.22 hours (95% CI -28.70 to -19.74 hours) in the time to results. Hospital length of stay was decreased by -0.82 days (95% CI -1.52 to -0.11 days). Among influenza positive patients, antivirals were more likely to be given (RR 1.25, 95% CI 1.06 to 1.48) and appropriate infection control facility use was more common with rapid multiplex PCR testing (RR 1.55, 95% CI 1.16 to 2.07).
Conclusions: our systematic review and meta-analysis demonstrates a reduction in time to results and length of stay for patients overall along with improvements in appropriate antiviral and infection control management among influenza positive patients. This evidence supports the routine use of rapid sample-to-answer multiplex PCR testing for respiratory viruses in the hospital setting.
COVID-19, Clinical impact, Influenza, Multiplex PCR, Rapid test, Respiratory virus, Syndromic panel
462–475
Clark, Tristan
712ec18e-613c-45df-a013-c8a22834e14f
Lindsley, Kristina
1d3dc074-1197-470a-9949-493fe2d45d5b
Wigmosta, Tara
032d4a1a-a14a-44c2-88c5-c6e28acfead3
Hemmert, Rachael
b2870732-43e7-416d-adb6-1f729f5a1041
Uyei, Jennifer
0c11f5b8-010a-412b-a90b-d75e8de28567
Timbrook, Tristan
60c18234-9c8a-4ac4-ab43-66f30f5b0201
May 2023
Clark, Tristan
712ec18e-613c-45df-a013-c8a22834e14f
Lindsley, Kristina
1d3dc074-1197-470a-9949-493fe2d45d5b
Wigmosta, Tara
032d4a1a-a14a-44c2-88c5-c6e28acfead3
Hemmert, Rachael
b2870732-43e7-416d-adb6-1f729f5a1041
Uyei, Jennifer
0c11f5b8-010a-412b-a90b-d75e8de28567
Timbrook, Tristan
60c18234-9c8a-4ac4-ab43-66f30f5b0201
Clark, Tristan, Lindsley, Kristina, Wigmosta, Tara, Hemmert, Rachael, Uyei, Jennifer and Timbrook, Tristan
(2023)
Rapid multiplex PCR for respiratory viruses reduces time to result and improves clinical care: results of a systematic review and meta-analysis.
Journal of Infection, 86 (5), .
(doi:10.1016/j.jinf.2023.03.005).
Abstract
Objectives: the clinical impact of rapid sample-to-answer ‘syndromic’ multiplex polymerase chain reaction (PCR) testing for respiratory viruses is not clearly established. We performed a systematic literature review and meta-analysis to evaluate this impact for patients with possible acute respiratory tract infection in the hospital setting.
Methods: we searched EMBASE, MEDLINE, and Cochrane databases from 2012 to present and conference proceedings from 2021 for studies comparing clinical impact outcomes between multiplex PCR testing and standard testing.
Results: twenty-seven studies with 17,321 patient encounters were included in this review. Rapid multiplex PCR testing was associated with a reduction of -24.22 hours (95% CI -28.70 to -19.74 hours) in the time to results. Hospital length of stay was decreased by -0.82 days (95% CI -1.52 to -0.11 days). Among influenza positive patients, antivirals were more likely to be given (RR 1.25, 95% CI 1.06 to 1.48) and appropriate infection control facility use was more common with rapid multiplex PCR testing (RR 1.55, 95% CI 1.16 to 2.07).
Conclusions: our systematic review and meta-analysis demonstrates a reduction in time to results and length of stay for patients overall along with improvements in appropriate antiviral and infection control management among influenza positive patients. This evidence supports the routine use of rapid sample-to-answer multiplex PCR testing for respiratory viruses in the hospital setting.
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JoI Meta 2023 proofs. pdf
- Accepted Manuscript
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More information
Accepted/In Press date: 2 March 2023
e-pub ahead of print date: 9 March 2023
Published date: May 2023
Additional Information:
Funding Information:
BioMerieux sponsored and funded this study and manufacturers a rapid multiplex PCR test for respiratory tract infections; however, the SLR included eligible tests by type and not by any specific manufacturer.
Publisher Copyright:
© 2023 The Authors
Keywords:
COVID-19, Clinical impact, Influenza, Multiplex PCR, Rapid test, Respiratory virus, Syndromic panel
Identifiers
Local EPrints ID: 477228
URI: http://eprints.soton.ac.uk/id/eprint/477228
ISSN: 0163-4453
PURE UUID: 84e1f69b-9f8f-4460-aa5e-c51178559e5b
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Date deposited: 01 Jun 2023 16:50
Last modified: 17 Mar 2024 03:34
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Contributors
Author:
Kristina Lindsley
Author:
Tara Wigmosta
Author:
Rachael Hemmert
Author:
Jennifer Uyei
Author:
Tristan Timbrook
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