@article{PAR00007814,
  title = {{R}evolutionizing clinical microbiology laboratory organization in hospitals with in situ point-of-care},
  author = {{C}ohen-{B}acrie, {S}. and {N}inove, {L}. and {N}ougairede, {A}. and {C}harrel, {R}. and {R}ichet, {H}. and {M}inodier, {P}. and {B}adiaga, {S}. and {N}oel, {G}. and {L}a {S}cola, {B}. and de {L}amballerie, {X}avier and {D}rancourt, {M}. and {R}aoult, {D}idier},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {C}linical microbiology may direct decisions regarding hospitalization, isolation and anti-infective therapy, but it is not effective at the time of early care. {P}oint-of-care ({POC}) tests have been developed for this purpose. {M}ethods and {F}indings: {O}ne pilot {POC}-lab was located close to the core laboratory and emergency ward to test the proof of concept. {A} second {POC}-lab was located inside the emergency ward of a distant hospital without a microbiology laboratory. {T}wenty-three molecular and immuno-detection tests, which were technically undemanding, were progressively implemented, with results obtained in less than four hours. {F}rom 2008 to 2010, 51,179 tests yielded 6,244 diagnoses. {T}he second {POC}-lab detected contagious pathogens in 982 patients who benefited from targeted isolation measures, including those undertaken during the influenza outbreak. {POC} tests prevented unnecessary treatment of patients with non-streptococcal tonsillitis (n = 1,844) and pregnant women negative for {S}treptococcus agalactiae carriage (n = 763). {T}he cerebrospinal fluid culture remained sterile in 50% of the 49 patients with bacterial meningitis, therefore antibiotic treatment was guided by the molecular tests performed in the {POC}-labs. {W}ith regard to enterovirus meningitis, the mean length-of-stay of infected patients over 15 years old significantly decreased from 2008 to 2010 compared with 2005 when the {POC} was not in place (1.43 +/- 1.09 versus 2.91 +/- 2.31 days; p = 0.0009). {A}ltogether, patients who received {POC} tests were immediately discharged nearly thrice as often as patients who underwent a conventional diagnostic procedure. {C}onclusions: {T}he on-site {POC}-lab met physicians' needs and influenced the management of 8% of the patients that presented to emergency wards. {T}his strategy might represent a major evolution of decision-making regarding the management of infectious diseases and patient care.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {6},
  numero = {7},
  pages = {e22403},
  ISSN = {1932-6203},
  year = {2011},
  DOI = {10.1371/journal.pone.0022403},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00007814},
}