Evaluation of the rapid influenza diagnostic system in nursing homes for the elderly (Ehpad). Provence-Alpes-Côte d'Azur, 2012–2013 flu season

During the 2012–2013 flu season, the Provence-Alpes-Côte d'Azur (PACA) Regional Health Agency (ARS) provided the 612 nursing homes for dependent elderly individuals (Ehpad) with nasopharyngeal swabs and 29 laboratories with rapid diagnostic influenza tests (TROD). This initiative aimed to facilitate access to influenza diagnosis, limit the inappropriate use of antibiotics, and describe viral circulation within the Ehpad facilities during the flu season. Thus, for any suspected case of influenza in a resident, the Ehpad facilities collected clinical data and performed a Trod swab, which was analyzed by one of the participating laboratories. The samples were then analyzed using multiplex RT-PCR to verify the results and screen for other viruses (adenovirus, enterovirus, parainfluenza virus, influenza virus, respiratory syncytial virus, metapneumovirus, rhinovirus, and coronavirus). At the request of the ARS Paca, Cire Sud (the regional unit of the French Institute for Public Health Surveillance (InVS) covering the Paca and Corsica regions) evaluated the use and acceptability of the system using a questionnaire distributed to all nursing homes and laboratories, as well as the performance of the Trod tests used within this system. Overall, the program was deemed satisfactory by 75% of the 311 nursing homes that responded to the survey. They emphasized the value of the distribution of swabs and the training initiatives conducted by a regional working group. The difficulties primarily concerned the transport of samples to participating laboratories. For their part, all laboratories welcomed the program, which they considered very useful, but some encountered difficulties related to the need to integrate new analytical techniques into their routine. Overall, the vast majority of nursing homes and laboratories wished to repeat the initiative during the next season, but without distributing Trod kits, as the laboratories were already equipped. In total, 62 samples were analyzed, representing 62 cases. This limited number of samples can be explained by a less severe flu epidemic among the elderly in the Provence-Alpes-Côte d’Azur (PACA) region and by the study’s late start relative to the period of circulation of the viruses under investigation. Multiplex RT-PCR doubled the number of positive results, reaching a rate of 52%, highlighting the diversity of viral circulation. Following this evaluation, the ARS decided to continue the program during the 2013–2014 flu season. (R.A.)

Author(s): Succo T

Publishing year: 2014

Pages: 38 p.

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