Effects of Rapid Influenza Antigen Test on Antimicrobial Management of Pediatric Patients with Influenza-Like Illness in the Emergency Room

Background@#Influenza is a commonly encountered respiratory tract infection and diagnosis remains to be a challenge. Use of a rapid antigen test may influence decisions on treatment in the emergency room (ER). @*Objectives@#This research aims to determine the effects of rapid influenza antigen test (RIAT) on antimicrobial management of influenza-like illness (ILI) in the ER, determine the clinical profile of pediatric patients with ILI and look into the relationship between RIAT result, symptomatology, and immunization status. @*Methods@#This is a cross-sectional study which involved review of charts of 195 pediatric patients with ILI who underwent RIAT (KlintecTM) through a nasopharyngeal swab in the ER of a tertiary hospital from September 2019 to February 2020. Chi-square, Fischer exact test and likelihood ratio were used for data analysis. @*Results@#Most pediatric patients were 7–12 years old males. Majority presented with fever, cough, and colds and underwent RIAT at 2–4 days from onset of illness. About 73.33% of study participants did not receive their yearly influenza vaccine and 70.7% of patients with positive RIAT had no influenza vaccine. There is a lower percentage of vaccinated children who developed cough (86.5% vs. 89.5%) and colds (80.8% vs. 83.2%) when compared with unvaccinated children. RIAT result significantly affected management in terms of antimicrobial prescribing to patients with ILI. @*Conclusion@# Influenza presents with non-specific symptoms and vaccination remains a major preventive measure against the disease. The result of RIAT facilitates targeted treatment for influenza and decreases unnecessary antibacterial use, but this should be done with careful thought and interpretation.

Comparison of SD BIOLINE Rapid Influenza Antigen Test Using Two Different Specimens, Nasopharyngeal Swabs and Nasopharyngeal Aspirates / 대한임상미생물학회지

BACKGROUND: The pandemic swine origin influenza A/H1N1 2009 virus (H1N1 2009) was rapidly spread out all over the world after it was first found in April, 2009. This study was made to compare the performance of nasopharyngeal swabs and nasopharyngeal aspirates for the SD Bioline rapid influenza antigen test. METHODS: From Aug to Nov, 2009 the SD Bioline rapid influenza antigen tests were conducted with the nasopharyngeal swabs and the nasopharyngeal aspirates from the 244 specimens of patients who had come to the hospital with influenza-like illness. The data from the examination were compared with the multiplex RT-PCR as a reference standard to obtain sensitivity, specificity, positive predictive value and negative predictive value. RESULTS: The sensitivity and the specificity of the SD Bioline rapid influenza antigen tests with the nasopharyngeal swabs were 75.8%, and 93.3% respectively, and the sensitivity and specificity with the nasopharyngeal aspirates were 61.3%, and 98.3% respectively. CONCLUSION: Even if the nasopharyngeal aspirates showed the lower sensitivity than the nasopharyngeal swabs, since the specificity is higher, the nasopharyngeal aspirates are more useful because we can reduce false positive rate.