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Cited by 34Viral Infections and Immunology ResearchNeonatal and Maternal InfectionsInfectious Encephalopathies and Encephalitis

Cerebrospinal Fluid Enterovirus Testing in Infants 56 Days or Younger

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Dewan, Maya, Zorc, Joseph J., Hodinka, Richard L., Shah, Samir S.·2010·Archives of Pediatrics & Adolescent Medicine
DOI 10.1001/archpediatrics.2010.153PMC PMC12450295
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Abstract

OBJECTIVE: To determine whether cerebrospinal fluid (CSF) enterovirus polymerase chain reaction (PCR) testing of febrile neonates is associated with a shorter hospital length of stay (LOS). DESIGN: Retrospective cohort study. SETTING: Urban tertiary care children's hospital emergency department. PARTICIPANTS: Febrile infants 56 days or younger evaluated by means of lumbar puncture. MAIN EXPOSURE: Performance of CSF enterovirus PCR testing. MAIN OUTCOME MEASURE: Hospital LOS. RESULTS: A CSF enterovirus PCR test was performed in 361 of 1231 eligible infants (29.3%); 89 of those tested (24.7%) were positive. The median LOS was 2 days. In multivariable analysis, CSF enterovirus PCR testing was associated with a 26.0% shorter LOS for infants with a positive test result (adjusted beta coefficient, -0.305; 95% confidence interval, -0.457 to -0.153; P < .001) and an 8.0% longer LOS for those with a negative test result (0.075; -0.021 to 0.171; P = .12) compared with untested infants. In stratified analysis, LOS was shorter for all infants 28 days or younger who tested positive regardless of receipt of antibiotics before lumbar puncture. For infants 29 to 56 days old, a positive test result was associated with a shorter LOS only in those not previously receiving antibiotics. The median (interquartile range) turnaround time for CSF enterovirus PCR testing was 22.2 (15.1-27.4) hours, with no effect of turnaround time on LOS. CONCLUSIONS: Among infants 56 days or younger, a positive CSF enterovirus PCR test result was associated with a shorter LOS compared with untested infants. The CSF enterovirus PCR test may improve the care of infants with fever.

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  • It has been shown in a number of studies that rapid detection of EV can decrease unnecessary antimicrobials, length of hospital stay, and hospital costs.

    “it has been shown in a number of studies that rapid detection of EV can decrease unnecessary antimicrobials, length of hospital stay, and hospital costs (5, 7, 20).”

    From Retrospective Evaluation of Infants Aged 1 to 60 Days with Residual Cerebrospinal Fluid (CSF) Tested Using the FilmArray Meningitis/Encephalitis (ME) Panel (2018) · cites this paper as [20]

    The Results (Hospital LOS; page unavailable) report that infants with a positive CSF enterovirus PCR result had a 26.0% shorter hospital stay than untested infants. The paper does not report reductions in antimicrobial use or hospital costs, and it found no overall difference in length of stay between tested and untested infants. It also found no effect of test turnaround time on length of stay, so the evidence is narrower than the claim about rapid detection. (LLM, conf=0.88)

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Research works printed but not linked: 1

  1. [3]Shah SS, Alpern E. Fever. In: Zauotis L, Change V, eds. Comprehensive Pediatric Hospital Medicine. Philadelphia, PA: Mosby Inc; 2007: 314– 323.

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Authors
Dewan, M., Zorc, J. J., Hodinka, R. L., & Shah, S. S.
Affiliations
Children's Hospital of Philadelphia (US)
ORCID
Venue
Archives of Pediatrics & Adolescent Medicine
Publisher
American Medical Association (AMA)
Published
2010-09-01
Volume
164
Issue
9
Pages
824-30
ISSN
1072-4710 (ISSN-L)
DOI
10.1001/archpediatrics.2010.153
PMC
PMC12450295
OpenAlex
W2013788345
Cited by
34
References
50
Citations by year
2023: 2 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 6 · 2016: 2 · 2015: 1 · 2014: 3 · 2013: 1 · 2012: 4
FWCI
1.30
Type
journal article
Language
en
Open access
Locations
  • Archives of Pediatrics and Adolescent Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
Funders
National Institute of Allergy and Infectious Diseases (K01AI073729)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
febrile infants, neonatal fever, length of hospital stay, lumbar puncture, enterovirus infection, turnaround time, emergency department evaluation
MeSH terms
Emergency Service, Hospital, Enterovirus Infections, Female, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Length of Stay, Male, Meningitis, Aseptic, Retrospective Studies, Philadelphia, Cohort Studies, Multivariate Analysis, Polymerase Chain Reaction

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