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Scientific paper - Original scientific paper
Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19
Medicina Fluminensis : Medicina Fluminensis, 60 (2024), 4; 582-589. https://doi.org/10.21860/medflum2024_321537
Kureljak, Dunja; Šimić Ševerdija, Lidija; Krapić, Mia; Marinović, Iva; Lerga, Mate; Juranić Lisnić, Vanda; Pavletić, Martina

Institutional repository: Repository of the University of Rijeka, Faculty of Medicine

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Kureljak, D., Šimić Ševerdija, L., Krapić, M., Marinović, I., Lerga, M., Juranić Lisnić, V. & Pavletić, M. (2024). Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19. Medicina Fluminensis : Medicina Fluminensis, 60. (4), 582-589. doi: 10.21860/medflum2024_321537

Kureljak, Dunja, et al. "Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19." Medicina Fluminensis : Medicina Fluminensis, vol. 60, no. 4, 2024, pp. 582-589. https://doi.org/10.21860/medflum2024_321537

Kureljak, Dunja, Lidija Šimić Ševerdija, Mia Krapić, Iva Marinović, Mate Lerga, Vanda Juranić Lisnić and Martina Pavletić. "Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19." Medicina Fluminensis : Medicina Fluminensis 60, no. 4 (2024): 582-589. https://doi.org/10.21860/medflum2024_321537

Kureljak, D., et al. (2024) 'Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19', Medicina Fluminensis : Medicina Fluminensis, 60(4), pp. 582-589. doi: 10.21860/medflum2024_321537

Kureljak D, Šimić Ševerdija L, Krapić M, Marinović I, Lerga M, Juranić Lisnić V, and sur.. Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19. Medicina Fluminensis : Medicina Fluminensis [Internet]. 2024 December 01 [cited 2025 January 11];60(4):582-589. doi: 10.21860/medflum2024_321537

D. Kureljak, et al., "Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19", Medicina Fluminensis : Medicina Fluminensis, vol. 60, no. 4, pp. 582-589, December 2024. [Online]. Available at: https://urn.nsk.hr/urn:nbn:hr:184:387957. [Accessed: 11 January 2025]

Metadata
Title (croatian)Utjecaj laboratorijske dijagnostike uz krevet bolesnika na vrijeme obrade hitnih bolesnika tijekom pandemije COVID-19
Title (english)Impact of Point-of-Care Laboratory Diagnostics on Emergency Department Processing Times During the COVID-19 Pandemic
AuthorDunja Kureljak
AuthorLidija Šimić Ševerdija
AuthorMia Krapić
AuthorIva Marinović
AuthorMate Lerga
AuthorVanda Juranić Lisnić
AuthorMartina Pavletić
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Center for Proteomics)
Author's institutionUniversity of Rijeka
Faculty of Medicine
(Department of Anaesthesiology,reanimatology and Intensive Care)
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Emergency Medicine
Abstract (croatian)
U Objedinjenom hitnom bolničkom prijamu (OHBP) Kliničkog bolničkog centra Rijeka 2020. godine uspostavljeno je molekularno testiranje kraj kreveta bolesnika (engl. Point-of-care polymerase chain reaction; POC-PCR) na teški akutni respiratorni sindrom koronavirus 2 (engl. Severe acute respiratory syndrome coronavirus 2; SARS-CoV-2). Uz bolesnike sa sumnjom na infekciju virusom SARS-CoV-2 redovito su testirani i zaposlenici. Ova studija analizira utjecaj POC-PCR-a na vrijeme obrade uzoraka, učinkovitost metode zbirnog testiranja te postotak lažno negativnih brzih antigenskih testova (BAT) u usporedbi s POC-PCR-om. Materijali i metode: Istraživanje je uključivalo bolesnike OHBP-a, hospitalizirane bolesnike i bolničko osoblje. Bolesnicima su uzeti brisevi orofarinksa i nazofarinksa. Osoblje je testirano zbirnim testiranjem (engl. “pooling”) koje uključuje do pet briseva nazofarinksa u istoj testnoj epruveti. PCR u stvarnom vremenu modificiran je u POC-PCR, a metode su izvođene s automatskom ekstrakcijom nukleinskih kiselina ili bez ekstrakcije. Visoko prioritetni slučajevi testirani su koristeći multipleks QIAstat-Dx SARS-CoV-2 respiratorni panel. Rezultati: Prije integracije POC-PCR laboratorija u OHBP, medijani potrebnog vremena od prikupljanja uzoraka do PCR rezultata iznosili su 74,29 i 8,35 sati. Nakon otvorenja POC-PCR laboratorija 2021. g. medijan se smanjio na 3,25 sati 2021. g., 2,30 sati 2022. g. te konačno dosegnuo 1,30 sati 2023. g. Također, od ukupno 1608 BAT-ova testiranih tijekom perioda od tri mjeseca, 3,4 % bilo je lažno negativno. Uvođenjem zbirnog testiranja brisevi bolničkog osoblja obrađeni su unutar 2,30 sati, a u slučaju pozitivnog testa, unutar šest sati od početka svake smjene. Najteže kategorije pacijenata testirane su multipleks PCR-om i rezultati pokazuju da SARS-CoV-2 prevladava, a slijede ga rinovirus/enterovirus i virusi influence. Zaključak: Integracija POC-PCR dijagnostike u OHBP-u značajno je ubrzala obradu uzoraka i pokazala učinkovitost zbirnog testiranja među bolničkim osobljem, čime se smanjuje pritisak na sustav hitne medicine i potiče daljnji razvitak POC-PCR laboratorija.
Abstract (english)
Aim: In 2020 Emergency department (ED) in the Clinical hospital centre Rijeka established Point-of-care polymerase chain reaction (POC-PCR) testing for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition to suspect cases, the ED also regularly tested hospital employees. To reduce the number of samples, employee’s swab samples were pooled for testing. This study aimed to analyse the impact of POC-PCR on diagnostic samples’ processing times, evaluated the efficacy of the pooling method among hospital personnel, and determined percentage of false-negative rapid antigen tests (RATs) in comparison with POC-PCR. Materials and Methods: The study included ED patients, hospitalized patients, and hospital personnel. Patients underwent oropharyngeal and nasopharyngeal swabbing. Personnel were screened using the pooling method, combining up to five swabs per test tube. Real time PCR (RT-PCR) was modified to POC-PCR, with or without automated nucleic acid extraction. High-priority patients were tested using the Multiplex PCR QIAstat-Dx Respiratory SARS-CoV-2 Panel. Results: Before the POC-PCR laboratory was established, the median processing times from sample collection to PCR results were 74.29 and 8.35 hours, respectively. Following the establishment of the POC-PCR laboratory in 2021, the median further reduced to 3.25 hours in September 2021, 2.30 hours in September 2022, and eventually reached 1.30 hours in September 2023. Additionally, out of the total 1608 RATs conducted over a 3-month period, 3.4% were false negatives. The pooling method allowed hospital staff samples to be analysed within 2.30 hours, or in the case of a positive pool, within 6 hours of each shift. Multiplex PCR for severe ED patients showed predominant SARS-CoV-2, followed by Rhinovirus/Enterovirus, Influenza, and other Coronaviruses. Conclusion: POC-PCR integration in the ED has significantly reduced time to diagnoses and proved the efficacy of the pooling method, easing the burden on ED and paving the way for further POC-PCR laboratory development.
Keywords (croatian)
Keywords (english)
Languagecroatian
Languageenglish
Publication typeScientific paper - Original scientific paper
Publication statusPublished
Peer reviewPeer review
Publication versionPublished version
Journal titleMedicina Fluminensis : Medicina Fluminensis
Numberingvol. 60, no. 4, pp. 582-589
p-ISSN1847-6864
e-ISSN1848-820X
DOIhttps://doi.org/10.21860/medflum2024_321537
URN:NBNurn:nbn:hr:184:387957
Publication2024-12-01
Document URLhttps://hrcak.srce.hr/321537
Type of resourceText
Access conditionsOpen access
Terms of useLicence Attribution 4.0 International (CC BY 4.0) icon
Created on2024-12-02 08:03:40