Diagnostic testing in influenza and pertussis-related paediatric intensive care unit admissions, Queensland, Australia, 1997-2013

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evere respiratory infections make up a large proportion of Australian paediatric intensive care unit (ICU) admissions each year. Identification of the causative pathogen is important and informs clinical management.MethodsWe investigated the use of polymerase chain reaction (PCR) in the ICU-setting using data collated by the Australian and New Zealand Paediatric Intensive Care (ANZPIC) Registry from five ICUs in Queensland, Australia. We reviewed diagnostic testing among all pertussis and influenza-related paediatric ICU admissions between 01 January 1997 and 31 December 2013.ResultsThere were 177 influenza-related and 78 pertussis-related ICU admissions. Overall, 157 (89%) influenza-related admissions had an influenza-specific diagnostic test conducted, of which 129 (82%) had a PCR test requested. Patients that were tested for influenza using non-PCR tests all occurred prior to 2007. An influenza-positive result was recorded for 130 (82%) of the tested influenza-related ICU admissions – 73% of all ICU admitted influenza-related cases. Among pertussis-related admissions, 63 (81%) had a pertussis-specific diagnostic test ordered, of which 60 (95%) were tested using PCR. A pertussis-positive result was recorded for 53 (86%) of those tested, and 68% of all ICU admitted pertussis-related admissions.ConclusionsPCR has become the preferred diagnostic method to test influenza and pertussis-related ICU admissions, largely replacing other methods. This finding mirrors trends observed across other health care settings, but appears to have occurred earlier among ICU admissions. The move to PCR testing, has allowed more sensitive and rapid diagnosis of severe pertussis and influenza infections among children.

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