{"id":24494,"date":"2023-09-02T04:48:00","date_gmt":"2023-09-01T20:48:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=24494"},"modified":"2023-09-02T06:05:00","modified_gmt":"2023-09-01T22:05:00","slug":"lancet-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%96%91%e8%af%8a%e8%83%83%e8%82%a0%e7%82%8e%e7%9a%84%e6%88%90%e5%b9%b4%e4%bd%8f%e9%99%a2%e6%82%a3%e8%80%85%e8%bf%9b%e8%a1%8c%e8%83%83","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=24494","title":{"rendered":"[Lancet Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a\u7591\u8bca\u80c3\u80a0\u708e\u7684\u6210\u5e74\u4f4f\u9662\u60a3\u8005\u8fdb\u884c\u80c3\u80a0\u9053\u81f4\u75c5\u5fae\u751f\u7269\u5e8a\u65c1\u5206\u5b50\u76d1\u6d4b\u7684\u4e34\u5e8a\u5f71\u54cd"},"content":{"rendered":"\n

ARTICLES| VOLUME 23, ISSUE 8<\/a>, P945-955, AUGUST 2023Download Full Issue<\/p>\n\n\n\n

Clinical impact of syndromic molecular point-of-care testing for gastrointestinal pathogens in adults hospitalised with suspected gastroenteritis (GastroPOC): a pragmatic, open-label, randomised controlled trial<\/h1>\n\n\n\n

Nathan J Brendish, Kate R Beard, Ahalya K Malachira, et al<\/h3>\n\n\n\n

Lancet Infect Dis 2023; 8: 945-955 Published:April 25, 2023 DOI:https:\/\/doi.org\/10.1016\/S1473-3099(23)00066-X<\/a><\/h3>\n\n\n\n

Summary<\/h2>\n\n\n\n

Background<\/h3>\n\n\n\n

Single-occupancy isolation rooms are a finite resource in UK hospitals but are crucial in preventing transmission of infection. Patients with suspected gastroenteritis are nursed in single-occupancy rooms, but delays in laboratory testing lead to non-infectious patients remaining isolated for prolonged periods unnecessarily. Rapid molecular test panels for gastrointestinal pathogens have a run time of around 1 h but their clinical impact is unknown. We aimed to evaluate the clinical impact of syndromic molecular point-of-care testing (mPOCT) for gastrointestinal pathogens in adult patients presenting to hospital with suspected gastroenteritis on single-occupancy room use and a range of other outcome measures.<\/p>\n\n\n\n

Methods<\/h3>\n\n\n\n

In this pragmatic, open-label, randomised controlled trial, we enrolled adults hospitalised with suspected gastroenteritis in a large UK hospital. Patients were randomly allocated (1:1) to receive syndromic mPOCT of stool or rectal samples, or to routine clinical care (control) with laboratory testing. The primary outcome was the duration of time in single-occupancy rooms assessed on a modified intention-to-treat basis. Secondary outcomes included the time to results, time to de-isolation, antibiotic use, and safety outcomes. The study was registered with ISRCTN, ISRCTN88918395, and is complete.<\/p>\n\n\n\n

Findings<\/h3>\n\n\n\n

Between March 20, 2017 and March 17, 2020, from 455 patients assessed for eligibility, we enrolled 278 patients, 138 assigned to mPOCT (one withdrawal) and 140 to the control group. The duration (geometric mean) of single-occupancy room isolation was 1\u00b78 days (95% CI 1\u00b75\u20132\u00b72) in the mPOCT group compared with 2\u00b76 days (2\u00b72\u20133\u00b70) in the control group (exponentiated coefficient 0\u00b770 [95% CI 0\u00b756 to 0\u00b787]; p=0\u00b70017). The median (IQR) time to results was 1\u00b77 h (1\u00b75\u20132\u00b70) for mPOCT and 44\u00b77 h (21\u00b72\u201366\u00b71) for the control group (p<0\u00b70001). Time to de-isolation was 0\u00b76 days (0\u00b73\u20131\u00b78) in the mPOCT group compared with 2\u00b72 days (1\u00b72\u20133\u00b72) in the control group, (p<0\u00b70001). Antibiotics were given in 89 (65%) of 137 in the mPOCT group and 66 (47%) of 140 in the control group (p=0\u00b70028). There were no differences between groups in length of hospital stay, or in safety outcomes including mortality, intensive care unit admission, or readmission to hospital.<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

mPOCT for gastrointestinal pathogens in patients with suspected gastroenteritis returned results more rapidly than conventional testing and was associated with a reduction in single-occupancy room use. However, these benefits need to be balanced against a potential increase in antibiotic use.<\/p>\n\n\n\n

Funding<\/h3>\n\n\n\n

University Hospital Southampton NHS Foundation Trust.<\/p>\n","protected":false},"excerpt":{"rendered":"

ARTICLES| VOLUME 23, ISSUE 8, P945-955,  […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24494"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=24494"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24494\/revisions"}],"predecessor-version":[{"id":24495,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/24494\/revisions\/24495"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=24494"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=24494"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=24494"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}