Association of Herpes Simplex Virus Testing with Hospital Length of Stay for Infants ≤60 Days of Age Undergoing Evaluation for Meningitis
Open accessAbstract
Although neonatal herpes simplex virus (HSV) causes significant morbidity, utilization of the cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) test remains variable. Our objective was to examine the association of CSF HSV PCR testing with length of stay (LOS) in a 20‐center retrospective cohort of hospitalized infants aged ≤60 days undergoing evaluation for meningitis after adjustment for patient‐level factors and clustering by center. Of 20,496 eligible infants, 7,399 (36.1%) had a CSF HSV PCR test performed, and 46 (0.6% of those tested) had a positive test. Infants who had a CSF HSV PCR test performed had a 23% longer hospital LOS (incident rate ratio 1.23; 95% CI: 1.14‐1.33). Targeted CSF HSV PCR testing may mitigate the impact on LOS for low‐risk infants.
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Thomson, J., Sucharew, H., Cruz, A. T., Nigrovic, L. E., Freedman, S. B., Garro, A. C., Balamuth, F., Mistry, R. D., Arms, J. L., Ishimine, P. T., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-3405 · Cited by 81 · see citing works
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Research works printed but not linked: 10
- [1]Kimberlin DW, Lin CY, Jacobs RF, et al. Natural history of neonatal herpes simplex virus infections in the acyclovir era. Pediatrics. 2001;108(2):223–229. doi: 10.1542/peds.108.2.223. [DOI] [PubMed] [Google Scholar] · DOI · Paper page
- [2]Shah SS, Aronson PL, Mohamad Z, Lorch SA. Delayed acyclovir therapy and death among neonates with herpes simplex virus infection. Pediatrics. 2011;128(6):1153–1160. doi: 10.1136/eb-2012-100674. doi: 10.1136/eb-2012-100674. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
- [3]Cruz AT, Freedman SB, Kulik DM, et al. Herpes simplex virus infection in infants undergoing meningitis evaluation. Pediatrics. 2018;141(2):e20171688. doi: 10.1542/peds.2017-1688. doi: 10.1542/peds.2017-1688. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
- [4]Shah SS, Volk J, Mohamad Z, Hodinka RL, Zorc JJ. Herpes simplex virus testing and hospital length of stay in neonates and young infants. J Pediatr. 2010;156(5):738–743. doi: 10.1016/j.jpeds.2009.11.079. doi: 10.1016/j.jpeds.2009.11.079. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
- [5]Mahajan P, Kuppermann N, Mejias A, et al. Association of RNA biosignatures with bacterial infections in febrile infants aged 60 days or younger. JAMA. 2016;316(8):846–857. doi: 10.1001/jama.2016.9207. doi: 10.1001/jama.2016.9207. [DOI] [PMC free article] [PubMed] [Google Scholar] · DOI
- [6]Schnadower D, Kuppermann N, Macias CG, et al. Febrile infants with urinary tract infections at very low risk for adverse events and bacteremia. Pediatrics. 2010;126(6):1074–1083. doi: 10.1542/peds.2010-0479. doi: 10.1542/peds.2010-0479. [DOI] [PubMed] [Google Scholar] · DOI
- [8]Caviness AC, Demmler GJ, Almendarez Y, Selwyn BJ. The prevalence of neonatal herpes simplex virus infection compared with serious bacterial illness in hospitalized neonates. J Pediatr. 2008;153(2):164–169. doi: 10.1016/j.jpeds.2008.02.031. doi: 10.1016/j.jpeds.2008.02.031. [DOI] [PubMed] [Google Scholar] · DOI
- [9]Long SS. In defense of empiric acyclovir therapy in certain neonates. J Pediatr. 2008;153(2):157–158. doi: 10.1016/j.jpeds.2008.04.071. doi: 10.1016/j.jpeds.2008.04.071. [DOI] [PubMed] [Google Scholar] · DOI
- [10]Brower L, Schondelmeyer A, Wilson P, Shah SS. Testing and empiric treatment for neonatal herpes simplex virus: challenges and opportunities for improving the value of care. Hosp Pediatr. 2016;6(2):108–111. doi: 10.1542/hpeds.2015-0166. doi: 10.1542/hpeds.2015-0166. [DOI] [PubMed] [Google Scholar] · DOI
- [11]Kimberlin DW. When should you initiate acyclovir therapy in a neonate? J Pediatr. 2008;153(2):155–156. doi: 10.1016/j.jpeds.2008.04.027. doi: 10.1016/j.jpeds.2008.04.027. [DOI] [PubMed] [Google Scholar] · DOI
Cited by
Sorted by citations
Herpetic viral dominance in pediatric meningitis and meningoencephalitis
Mishra, P., Pandey, S. C., Shukla, S. K., Sharma, A., Singh, S. P., Jais, M. B., Tiwari, S., Gogoi, S., & Yadav, V. (2026) · Bioinformation · doi:10.6026/973206300221448
- Authors
- Aronson, P. L., Cruz, A. T., Freedman, S. B., Balamuth, F., Grether‐Jones, K. L., Lyons, T. W., Fleming, A. H., Louie, J., Mistry, R. D., Garro, A. C., Shah, S. S., Nigrovic, L. E., & Pediatric Emergency Medicine Clinical Research Network (PEM CRC) Herpes Simplex Virus (HSV) Study Group
- Affiliations
- Yale University (US)
- Baylor College of Medicine (US)
- University of Calgary (CA)
- Children's Hospital of Philadelphia (US)
- Department of Emergency Medicine University of California Davis School of Medicine Sacramento California
- Boston Children's Hospital (US)
- Emory University (US)
- University of Minnesota (US)
- University of Colorado Anschutz (US)
- Brown University (US)
- Cincinnati Children's Hospital Medical Center (US)
- Corresponding author
- Aronson, Paul L
- ORCID
- Venue
- Journal of Hospital Medicine
- Publisher
- Wiley
- Published
- 2019-08
- Volume
- 14
- Issue
- 8
- Pages
- 492-495
- ISSN
- 1553-5592 (ISSN-L)
- 1553-5606
- PMC
- PMC6686736
- OpenAlex
- W2946439029
- Cited by
- 11
- References
- 1
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2
- FWCI
- 0.95
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Hospital Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- American Academy of Pediatrics
- Agency for Healthcare Research and Quality
- Topics
- Health Sciences › Medicine › Epidemiology › Herpesvirus Infections and Treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
- Keywords
- herpes simplex virus, neonatal herpes, length of hospital stay, infants, meningitis, diagnostic testing utilization, low-risk infants, pediatric hospitalization
- MeSH terms
- Emergency Service, Hospital, Female, Herpes Simplex, Hospitals, Humans, Infant, Infant, Newborn, Length of Stay, Male, Meningitis, Pregnancy Complications, Infectious, Retrospective Studies, Polymerase Chain Reaction, Simplexvirus
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