Point-of-care testing by healthcare workers for detection of meticillin-resistant Staphylococcus aureus, Clostridioides difficile, and norovirus

S. Dewar (Lead / Corresponding author), D. Vass, F. M. Mackenzie, B. J. Parcell

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    Abstract

    Background: The feasibility of introducing three separate Cepheid GeneXpert® assays was assessed: Xpert SA Nasal Complete, Xpert C. difficile, and Xpert Norovirus for point-of-care testing (POCT) on a ward in a district general hospital.

    Aim: To establish a seven-day/24 h POCT service for meticillin-resistant Staphylococcus aureus (MRSA), Clostridioides difficile, and norovirus operated solely by healthcare workers (HCWs).

    Methods: The Cepheid GeneXpert assays performance characteristics were assessed by comparing the assays to traditional central laboratory methods in terms of clinical turnaround times, hands-on time, number of process steps, time to result and diagnostic accuracy. HCW feedback was collected to consider the potential added value of applying this technology to improve patient flow and clinical care.

    Findings: In total 1170 tests were carried out over the 16-month study period. The assays significantly reduced hands-on time, process steps, and time to result for identification of all three micro-organisms. Overall agreement with central laboratory testing was >98% for all three assays. Staff members fed back that POCT had a positive impact in terms of clinical utility.

    Conclusion: Xpert SA Nasal Complete for MRSA detection, Xpert C. difficile, and Xpert Norovirus can be used as POCT solely by HCWs in a ward setting. Each assay was used throughout a seven-day/24 h period with potential positive impact on bed management and patient care.

    Original languageEnglish
    Pages (from-to)447-453
    Number of pages7
    JournalJournal of Hospital Infection
    Volume103
    Issue number4
    Early online date9 Aug 2019
    DOIs
    Publication statusPublished - Dec 2019

    Keywords

    • Cepheid
    • Clostridioides difficile
    • MRSA
    • Norovirus
    • POCT
    • Point-of-care

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