Authors (including presenting author) :
Kelvin K. W. To (1), Sik-Hon Tsui (2), C. L. Tang (2) Yim-Ping Choi (2), Ka-Yee Lo (2), Shuk-Ching Wong (3), Vincent C. C. Cheng (1,3), Ivan F. N. Hung (4), Kwok-Yung Yuen (1)
Affiliation :
1) Department of Microbiology, Queen Mary Hospital and the University of Hong Kong 2) Department of Accident and Emergency, Queen Mary Hospital 3) Infection Control Team, Queen Mary Hospital 4) Department of Medicine, Queen Mary Hospital and the University of Hong Kong
Introduction :
Seasonal influenza epidemics cause significant disturbance to the healthcare system. Despite the use of rapid molecular assays in clinical microbiology laboratory, the turnaround time of respiratory virus testing is still prolonged due to delay in specimen collection. Our previous study has demonstrated that saliva, a convenient specimen type, can be used for respiratory virus testing with high sensitivity and specificity. During the 2018/2019 winter influenza season, we started a “throat-saliva respiratory virus testing program” in which triage nurses at the Department of Accident and Emergency (AED) of Queen Mary Hospital (QMH) were empowered to collect throat saliva from patients for respiratory virus testing.
Objectives :
To analyze the impact of “throat saliva respiratory virus testing program”
Methodology :
Data on influenza virus testing was retrieved from the Laboratory information System. Data of hospitalized adult influenza patients were retrieved from Laboratory information System and Clinical Data Analysis and Reporting System (CDARS). Time to laboratory diagnosis, duration of bed occupancy and length of hospital stay of influenza patients admitted to QMH during the 2019 winter influenza season were compared to those from influenza patients admitted during 2016/2017 influenza season, and 2018 winter influenza season.
Result & Outcome :
During the 2018/2019 winter influenza season, a total of 850 throat saliva specimens were collected from adult patients the AED, and influenza virus or respiratory syncytial virus was detected in 331 (38.9%) specimens. When compared to influenza patients admitted to QMH in previous influenza seasons, influenza patients admitted to QMH during the 2018/2019 winter influenza season had a significantly shorter time to laboratory diagnosis (median: 4.1 hours in 2019 winter vs 6.7 in 2018 winter vs 21.1 in 2016/2017) and length of hospital stay in QMH (median: 31.6 hours in 2019 winter vs 44.5 hours in 2018 winter vs 39.6 hours in 2016/2017). A significantly higher proportion of patients were discharged within 24 hours during the 2018/2019 winter influenza season than in previous influenza seasons (25.9% in 2019 winter vs 14.6% in 2018 winter vs 16.5% in 2016/2017). The introduction of throat saliva respiratory virus testing program has significantly reduced the impact of influenza epidemic on the hospital.
