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Cited by 60Viral Infections and Immunology ResearchInfectious Encephalopathies and EncephalitisBacterial Infections and Vaccines

Clinical benefits of introducing real-time multiplex PCR for cerebrospinal fluid as routine diagnostic at a tertiary care pediatric center

Eichinger, Anna, Hagen, Alexandra, Meyer-Bühn, Melanie, Huebner, Johannes·2019·Infection
DOI 10.1007/s15010-018-1212-7
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Abstract

Background Sepsis-like illness with suspected meningitis or encephalitis is a common reason for using empiric antimicrobial therapy in infants and children. However, in cases of viral meningitis not covered by these antimicrobials, this management is ineffective and due to side effects potentially harmful.Methods A retrospective analysis of cerebrospinal fluid (CSF) multiplex PCRs (Biofire FilmArray®) in children with clinical suspicion of meningitis, encephalitis or sepsis-like illness was performed over the period of 1 year. Subsequently, a subgroup of children (age of 8-84 days of life) diagnosed with viral meningitis (enterovirus, HHV-6, human parechovirus) was compared to an age-matched control group.Results During the study period, the multiplex PCR panel was performed on 187 individual CSF samples that met the inclusion criteria. About half of the patients (92/187) were less than 1 year of age. In 27 cases (14.4%), the PCR yielded a positive result with the majority (12/27) being indicative of an enteroviral infection. In the age group of 8-84 days of life, 36.4% of the patients had a positive result. When the patients with a PCR positive for a viral agent were compared to an age-matched group of patients, no differences were observed regarding symptoms and laboratory parameters. However, the duration of antimicrobial therapy could be significantly reduced through the use of multiplex PCR.Conclusion The use of on-site diagnostic multiplex PCR was able to reduce the use of antimicrobials in selected cases. This test can guide clinical decisions earlier during the course of medical care compared to standard diagnostics.

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Crossref · 10.1007/s15010-018-1212-7

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35 of 35 references verified0 citation errors · 0 not checkable

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  • Previous reports have shown that EV infections cause relatively stable annual epidemics, while HPeV infections cause sporadic epidemics every few years.

    “Previous reports have shown that although EV infections cause relatively stable annual epidemics, HPeV infections cause sporadic epidemics every few years (11–17).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [12]

  • Previous studies using FA-M/E panels in pediatric patients exhibited pathogen detection rates ranging from 11.1% to 25.5%, with EV being the most commonly detected microorganism, with high frequency during the summer and autumn months in regions with temperate climates.

    “Previous studies using FA-M/E panels in pediatric patients exhibited pathogen detection rates ranging from 11.1% to 25.5%, with EV being the most commonly detected microorganism, with high frequency during the summer and autumn months in regions with temperate climates (11–14).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [12]

  • Compared with previous studies using FA-M/E panels, HPeV was identified more frequently, which may have reflected an endemic of HPeV infection in several regions in Japan during the study period.

    “Compared with previous studies using FA-M/E panels, HPeV was identified more frequently, which may have reflected an endemic of HPeV infection in several regions in Japan during the study period (11–14).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [12]

  • Previous studies have found that almost all children with HPeV infection were young infants, whereas EV infections were widely distributed across most age groups.

    “Previous studies have found that almost all children with HPeV infection were young infants, whereas EV infections were widely distributed across most age groups (11–17).”

    From Epidemiology of pediatric meningitis and encephalitis in Japan: a cross-sectional study (2024) · cites this paper as [12]

  • Frequent HHV-6 and Cytomegalovirus detection by FA-ME is reported by several authors, who in most cases considered them non-pathogenic due to latency capacity and chromosomal integration (HHV-6), and non-significance in immunocompetent patients (Cytomegalovirus).

    “Frequent HHV-6 and Cytomegalovirus detection by FA-ME is reported by several authors, who in most cases considered them non-pathogenic due to their latency capacity and chromosomal integration (HHV-6), and non-significance in immunocompetent patients (Cytomegalovirus) [17, 20, 31, 34–36].”

    From Clinical utility of the FilmArray® meningitis/encephalitis panel in children with suspected central nervous system infection in a low-resource setting – a prospective study in Southwestern Uganda (2025) · cites this paper as [36]

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Authors
Eichinger, A., Hagen, A., Meyer-Bühn, M., & Huebner, J.
Affiliations
LMU Klinikum (DE)
ORCID
Eichinger, Anna
Venue
Infection
Publisher
Springer Science and Business Media LLC
Published
2018-09-05
Volume
47
Issue
1
Pages
51-58
ISSN
  • 0300-8126 (ISSN-L)
  • 1439-0973
DOI
10.1007/s15010-018-1212-7
OpenAlex
W2889820525
Cited by
60
References
35
Citations by year
2026: 6 · 2025: 3 · 2024: 6 · 2023: 4 · 2022: 7 · 2021: 7 · 2020: 17 · 2019: 10
FWCI
6.51
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Infection (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
multiplex real-time PCR, cerebrospinal fluid, viral meningitis, encephalitis, sepsis-like illness, infants, enterovirus, human herpesvirus 6, human parechovirus, antibiotic duration, diagnostic yield, pediatric neurology
MeSH terms
Cerebrospinal Fluid, Child, Encephalitis, Female, Germany, Humans, Infant, Infant, Newborn, Male, Meningitis, Retrospective Studies, Sepsis, Multiplex Polymerase Chain Reaction, Real-Time Polymerase Chain Reaction, Tertiary Care Centers

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