Evaluation of Viruses Associated With Acute Respiratory Infections in Long-Term Care Facilities Using a Novel Method: Wisconsin, 2016‒2019.
Mary M Checovich, Shari Barlow, Peter Shult and 2 others
PMID 31636034WHAT IT FOUND
Nasal swabs from 497 long-term care residents with respiratory symptoms found a virus in 54.8% of tested specimens.
Influenza, human metapneumovirus, respiratory syncytial virus and coronavirus were common. This supports nurse-collected surveillance, not proven benefit.
Key findings
01Nasal swabs collected from 497 long-term care residents with acute respiratory infections yielded a virus in 54.8% of specimens tested by PCR.
02Influenza was the most common virus (31.8%), followed by human metapneumovirus (20.9%), and influenza A, influenza B, human metapneumovirus, and respiratory syncytial virus together accounted for 69% of detections.
03Virus detection was not related to resident age or time from symptom onset to specimen collection, but the mix of viruses changed significantly across years.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a substudy of a larger trial and was not designed to measure clinical benefit, so it cannot show that rapid testing improves outcomes or infection control. No clinical outcomes were linked to the virus results, so the study cannot say whether testing changed treatment, recovery, hospital transfer, or spread. Only 10 intervention sites were included, and they were less than 3% of Wisconsin long-term care facilities, so results may not apply to all facilities. Specimen transfer to the laboratory varied by year and was affected by courier changes, so the tested sample may not represent all residents with symptoms. The laboratory panel included a limited number of pathogens, so some respiratory infections may have been missed. Nursing staff selected which residents to swab based on observed symptoms, and the authors could not assess selection bias.
Declared interests
No conflicts of interest or funding statement is included in the supplied text. The article is tagged as supported by a non-U.S. government source.
The easy way to misread this
Do not conclude that nurse-collected rapid influenza testing improves resident outcomes or reduces transmission. This substudy only reported which viruses were found in swabs, did not link results to clinical outcomes, and was not designed to test effectiveness.