Rapid Influenza Diagnosis in Children With Serious Bacterial Infection-Like Symptoms.

Abstract

Aim: To evaluate the impact of the influenza diagnosis by the Quidel Sofia rapid influenza fluorescent immunoassay (FIA) on children presenting with serious bacterial infection (SBI)-like symptoms in an emergency department (ED).

Methods: A cohort study was conducted on 161 children with SBI-like symptoms, who underwent a Quidel Sofia test. The management of Influenza-positive and Influenza-negative children was compared on diagnostic tests, antibiotic use, and hospitalisation rates. Follow-up was performed 7-10 days post-discharge to confirm SBI non-omission.

Results: Influenza-positive children underwent fewer diagnostic tests, including fewer invasive tests, than influenza-negative children (58.1% vs. 90.7%, p < 0.001 and 47.7% vs. 72%, p = 0.002, respectively), received fewer antibiotics (10.5% vs. 33.3%, p < 0.001), had lower hospitalisation rates (20.9% vs. 40%, p = 0.008) and shorter ED visits (133 [52-257] minutes vs. 177 [92-273] minutes, p = 0.002). No influenza-positive patient had a missed SBI, even among the youngest patients. One developed a secondary SBI 4 days later resulting in death.

Conclusion: This study demonstrated the benefit of the influenza diagnosis by Quidel Sofia rapid influenza FIA in medical management without omitting SBI in children with SBI-like symptoms. Therefore, the Quidel Sofia test can help alleviate ED overcrowding during the influenza season while maintaining vigilance for bacterial co-infection.