title: Impact of Early Detection of Respiratory Viruses by Multiplex PCR Assay on Clinical Outcomes in Adult Patients.
abstract: Rapid and definitive diagnosis of viral respiratory infections is imperative in patient triage and management. We compared the outcomes for adult patients with positive tests for respiratory viruses at a tertiary care center across two consecutive influenza seasons (winters of 2010-2011 and 2012). Infections were diagnosed by conventional methods in the first season and by multiplex PCR (FilmArray) in the second season. FilmArray decreased the time to diagnosis of influenza compared to conventional methods (median turnaround times of 1.7 h versus 7.7 h, respectively; P = 0.015); FilmArray also decreased the time to diagnosis of non-influenza viruses (1.5 h versus 13.5 h, respectively; P < 0.0001). Multivariate logistic regression found that a diagnosis of influenza by FilmArray was associated with significantly lower odds ratios (ORs) for admission (P = 0.046), length of stay (P = 0.040), duration of antimicrobial use (P = 0.032), and number of chest radiographs (P = 0.005), when controlling for potential confounders. We conclude that the rapid turnaround time, multiplex nature of the test (allowing simultaneous detection of an array of viruses), and superior sensitivity of FilmArray may improve the evaluation and management of patients suspected of having respiratory virus infections.
authors.affiliation: Department of Medicine, Division of Clinical Epidemiology and Evaluative Sciences Research, Weill Cornell Medicine, New York, New York, USA rappou01@gmail.com.
authors.forename: Urania
authors.initials: U
authors.lastname: Rappo
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA.
authors.forename: Audrey N
authors.initials: AN
authors.lastname: Schuetz
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, New York, USA.
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Jenkins
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Calfee
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA Departments of Pediatrics and Microbiology & Immunology, Weill Cornell Medicine, New York, New York, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.affiliation: Department of Statistical Science, Cornell University, Ithaca, New York, USA.
authors.forename: Martin T
authors.initials: MT
authors.lastname: Wells
authors.affiliation: Department of Medicine, Division of Clinical Epidemiology and Evaluative Sciences Research, Weill Cornell Medicine, New York, New York, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Hollenberg
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Weill Cornell Medicine, New York, New York, USA.
authors.forename: Marshall J
authors.initials: MJ
authors.lastname: Glesby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000821:virology; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D014777:Virus Diseases / Q000175:diagnosis* / Q000821:virology; D014780:Viruses / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D055815:Young Adult