| Autor: |
Epstein L; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States.; Atlanta VA Healthcare System, Atlanta, Georgia, United States., Diekema DJ; Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States., Morgan DJ; Department of Epidemiology and Public Health, University of Maryland School of Medicine and VA Maryland Healthcare System, Baltimore, Maryland, United States., Fakih MG; Quality Department, Ascension Health Care, and Wayne State University School of Medicine, Detroit, Michigan, United States., Lee F; Departments of Pathology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States., Gottlieb L; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States., Leung E; Department of Pharmacy, St. Michael's Hospital/Unity Health Toronto, Toronto, Ontario, Canada., Yen C; Departments of Pathology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, United States., Sullivan KV; Department of Pathology & Laboratory Medicine, Lewis Katz School of Medicine at Temple University and Temple University Health System, Philadelphia, Pennsylvania, United States., Hayden MK; Division of Infectious Diseases, Department of Internal Medicine, Rush University, Chicago, Illinois, United States. |
| Abstrakt: |
The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the importance of stewardship of viral diagnostic tests to aid infection prevention efforts in healthcare facilities. We highlight diagnostic stewardship lessons learned during the COVID-19 pandemic and discuss how diagnostic stewardship principles can inform management and mitigation of future emerging pathogens in acute-care settings. Diagnostic stewardship during the COVID-19 pandemic evolved as information regarding transmission (eg, routes, timing, and efficiency of transmission) became available. Diagnostic testing approaches varied depending on the availability of tests and when supplies and resources became available. Diagnostic stewardship lessons learned from the COVID-19 pandemic include the importance of prioritizing robust infection prevention mitigation controls above universal admission testing and considering preprocedure testing, contact tracing, and surveillance in the healthcare facility in certain scenarios. In the future, optimal diagnostic stewardship approaches should be tailored to specific pathogen virulence, transmissibility, and transmission routes, as well as disease severity, availability of effective treatments and vaccines, and timing of infectiousness relative to symptoms. This document is part of a series of papers developed by the Society of Healthcare Epidemiology of America on diagnostic stewardship in infection prevention and antibiotic stewardship. 1 . |
