Published online August 31, 2007
PEDIATRICS Vol. 120 No. 3 September 2007, pp. 489-496 (doi:10.1542/peds.2007-0252)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via ISI Web of Science (2)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by King, R. L.
Right arrow Articles by Shah, S. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by King, R. L.
Right arrow Articles by Shah, S. S.
Related Collections
Right arrow Infectious Disease & Immunity

ARTICLE

Routine Cerebrospinal Fluid Enterovirus Polymerase Chain Reaction Testing Reduces Hospitalization and Antibiotic Use for Infants 90 Days of Age or Younger

Rebecca L. King, MDa, Scott A. Lorch, MD, MSCEb,c,d, Daniela M. Cohen, BSa, Richard L. Hodinka, PhDa,c,e, Keri A. Cohn, MDa and Samir S. Shah, MD, MSCEa,c,d,f

a Divisions of Infectious Diseases
b Neonatology
e Clinical Virology Laboratory, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
c Departments of Pediatrics
f Biostatistics and Epidemiology
d Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

OBJECTIVE. The goal was to evaluate the impact of cerebrospinal fluid enterovirus polymerase chain reaction testing on the length of hospitalization and the duration of antibiotic use for infants ≤90 days of age with suspected aseptic meningitis.

METHODS. This retrospective cohort study was conducted at an urban, tertiary-care children's hospital. Data were collected for 478 patients ≤90 days of age for whom cerebrospinal fluid enterovirus polymerase chain reaction testing was performed during the enteroviral seasons of 2000 to 2006. The length of hospitalization and the duration of antibiotic use were assessed.

RESULTS. Cerebrospinal fluid enterovirus polymerase chain reaction test results were positive for 154 patients (34.8%). The mean length of stay was 3.65 days. The median polymerase chain reaction turnaround time was 23 hours. In multivariate analysis, having a positive cerebrospinal fluid enterovirus polymerase chain reaction result was associated with a 1.54-day decrease in the length of stay and a 33.7% shorter duration of antibiotic use. When patients were stratified according to the presence or absence of pleocytosis, both groups demonstrated significant reductions in the length of stay with positive cerebrospinal fluid enterovirus polymerase chain reaction results (1.32 and 1.38 days, respectively). Furthermore, increasing the polymerase chain reaction turnaround time by 24 hours increased the length of stay by 13.6% for patients with positive cerebrospinal fluid enterovirus polymerase chain reaction results.

CONCLUSIONS. Having positive cerebrospinal fluid enterovirus polymerase chain reaction results decreases the length of hospitalization and the duration of antibiotic use for young infants. These results support the routine use of this test during periods of peak enterovirus prevalence.

Key Words: enterovirus • infant • polymerase chain reaction • aseptic meningitis

Abbreviations: CSF—cerebrospinal fluid • LOS—length of stay • PCR—polymerase chain reaction • WBC—white blood cell • CI—confidence interval

Accepted Apr 18, 2007.




This article has been cited by other articles:


Home page
 J. Clin. Microbiol.Home page
K. Seme, T. Mocilnik, K. F. Komlos, A. Doplihar, D. H. Persing, and M. Poljak
GeneXpert Enterovirus Assay: One-Year Experience in a Routine Laboratory Setting and Evaluation on Three Proficiency Panels
J. Clin. Microbiol., April 1, 2008; 46(4): 1510 - 1513.
[Abstract] [Full Text] [PDF]

Home page
 JWatch GeneralHome page
CSF PCR Testing for Enterovirus Reduces Length of Stay for Infants
Journal Watch (General), September 27, 2007; 2007(927): 5 - 5.
[Full Text]