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Point-of-care respiratory test shows promise for A&E

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A novel way of using a swab test can rapidly diagnose influenza and other viral infections in patients with severe respiratory conditions, resulting in shorter antibiotic courses and less time in hospital.

Developed at University Hospital Southampton NHS Foundation Trust and Southampton Biomedical Research Centre, the “point-of-care” testing strategy can be carried out in emergency departments and acute medical units.

“It tells us immediately what virus the person has”

Tristan Clark

It involves processing swabs immediately on a portable device combined with a rapid molecular test and, as samples do not need to be sent to the laboratory, results can be delivered within an hour as opposed to a number of days.

The system was trialled during the winters of 2015 and 2016, involving 720 patients with acute respiratory illness, including pneumonia and of asthma and chronic obstructive pulmonary disease exacerbations.

Half the patients had the point-of-care test, in which case a swab was analysed on the device and the results given to their treating clinician, while the other half received standard care.

Results, due to be published in the journal Lancet Respiratory Medicine, showed patients who had the point-of-care test got the right treatment for their lung condition faster.

In addition, patients who tested positive for flu in the point-of-care test group were appropriately isolated in a side room and given antiviral medication more often and sooner than the others.

Study author Dr Tristan Clark, a consultant in infectious diseases at the trust, said: “My vision is that anyone who comes into hospital with an acute respiratory condition will receive this point-of-care test as soon as they come through the hospital door.”

University Hospital Southampton NHS Foundation Trust/University of Southampton

Point-of-care respiratory test shows promise for A&E

Tristan Clark

“It tells us immediately what virus the person has so, for example, if they have flu they can be isolated in a side room and given antiviral drugs without delay,” said Dr Clark.

He suggested that tests like his, which enabled “tailored and personalised medicine”, could have a “major role to play in the fight against antibiotic resistance”.

“Lung infections in asthma and COPD patients are a common cause of antibiotic overuse,” said Dr Clark, who is also an associate professor in infectious diseases at Southampton University.

He noted that patients with respiratory infections were often given antibiotics “just in case when the cause of the infection is not immediately apparent”.

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