GastroPOC
Trial question
What is the role of syndromic molecular point-of-care testing in patients hospitalized with suspected gastroenteritis?
Study design
Single center
Open label
RCT
Population
Characteristics of study participants
49.0% female
51.0% male
N = 277
277 patients (137 female, 140 male).
Inclusion criteria: adult patients hospitalized with suspected gastroenteritis.
Key exclusion criteria: palliative approach being taken by treating clinician, previously included in the study and re-presenting within 30 days after hospital discharge, declination of stool sample or rectal swab.
Interventions
N=137 molecular point-of-care testing (syndromic molecular point-of-care testing of stool or rectal samples).
N=140 routine clinical care (stool testing done by standard laboratory testing at the discretion of clinical team).
Primary outcome
Duration of single-occupancy room isolation
1.8 days
2.6 days
2.6 days
2.0 days
1.3 days
0.7 days
0.0 days
Molecular point-of-care
testing
Routine clinical
care
Significant
decrease ▼
Significant decrease in duration of single-occupancy room isolation (1.8 days vs. 2.6 days; AD -0.8 days, 95% CI -1.3 to -0.3).
Secondary outcomes
Significantly shorter time to study results (1.7 hours vs. 44.7 hours; AD -43.9 hours, 95% CI -49.3 to -38.4).
Significantly shorter time to de-isolation (0.6 days vs. 2.2 days; AD -1.5 days, 95% CI -2.2 to -0.8).
Significant increase in antibiotic use (65% vs. 47%; AD 18%, 95% CI 6 to 29).
Safety outcomes
No significant differences in ICU admission, hospital deaths, readmission and re-presentation within 30 days.
Conclusion
In adult patients hospitalized with suspected gastroenteritis, molecular point-of-care testing was superior to routine clinical care with respect to duration of single-occupancy room isolation.
Reference
Nathan J Brendish, Kate R Beard, Ahalya K Malachira et al. Clinical impact of syndromic molecular point-of-care testing for gastrointestinal pathogens in adults hospitalised with suspected gastroenteritis (GastroPOC): a pragmatic, open-label, randomised controlled trial. Lancet Infect Dis. 2023 Aug;23(8):945-955.
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