Association of the filmarray meningitis/encephalitis panel with clinical management
Abstract
OBJECTIVES: To determine the association of the use of the multiplex assay meningitis/encephalitis panel with clinical management of suspected meningitis. METHODS: A cross-sectional study was conducted with children 0 to 18 years of age who received a lumbar puncture within 48 hours of admission for an infectious workup. Patient demographic and presenting information, laboratory studies, and medication administration were collected. The primary measure was length of stay (LOS) with secondary measures: time on antibiotics, time to narrowing antibiotics, and acyclovir doses. LOS and antibiotic times were stratified for outcomes occurring before 36 hours. Logistic regression analysis was used to account for potential confounding factors associated with both the primary and secondary outcomes. A value of P < .05 was considered statistically significant. RESULTS: Meningitis panel use was associated with a higher likelihood of a patient LOS <36 hours (P = .04; odds ratio = 1.7; 95% confidence interval [CI]: 1.03–2.87), a time to narrowing antibiotics <36 hours (P = .008; odds ratio = 1.89; 95% CI: 1.18–2.87), and doses of acyclovir (P < .001; incidence rate ratio = 0.37; 95% CI: 0.26–0.53). When controlling for potential confounding factors, these associations persisted. CONCLUSIONS: Use of the meningitis panel was associated with a decreased LOS, time to narrowing of antibiotics, and fewer acyclovir doses. This likely is a result of the rapid turnaround time as compared with cerebrospinal fluid cultures. Additional studies to examine the outcomes related to this change in management are warranted.
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Implementation of the ME Panel into clinical practice has yielded mixed results.
“Implementation of the ME Panel into clinical practice has yielded mixed results.”
Implementation of the ME Panel has been shown to reduce acyclovir days of therapy in several clinical pre-post analyses.
“Implementation of the ME Panel has also been shown to reduce acyclovir days of therapy in several clinical pre-post analyses [12,13,14,15].”
Some institutions have found a decreased length of stay associated with the ME Panel.
“Some institutions have found a decreased length of stay associated with the ME Panel [11,12].”
The reduction in acyclovir days of therapy mirrors findings from other studies.
“This mirrors findings from other studies, as previously discussed [12,13,14,15].”
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- Authors
- Nabower, A. M., Miller, S., Biewen, B., Lyden, E., Goodrich, N., Miller, A., Gollehon, N., Skar, G., & Snowden, J.
- Affiliations
- Department of Pediatrics and
- University of Nebraska–Lincoln (US)
- Creighton University (US)
- University of Nebraska Medical Center (US)
- University of Arkansas for Medical Sciences (US)
- Corresponding author
- Nabower, Aleisha M.
- ORCID
- Venue
- Hospital Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2019-10-01
- Volume
- 9
- Issue
- 10
- Pages
- 763-769
- ISSN
- 2154-1663 (ISSN-L)
- 2154-1671
- OpenAlex
- W2978839757
- Cited by
- 42
- References
- 20
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 4 · 2023: 3 · 2022: 14 · 2021: 6 · 2020: 7 · 2019: 1
- FWCI
- 5.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hospital Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- FilmArray Meningitis/Encephalitis panel, multiplex PCR, bacterial meningitis, encephalitis, pediatric patients, length of hospital stay, antibiotic stewardship, cerebrospinal fluid culture, diagnostic turnaround time, clinical management
- MeSH terms
- Acyclovir, Anti-Bacterial Agents, Antiviral Agents, Cross-Sectional Studies, Enterovirus Infections, Female, Humans, Infant, Infant, Newborn, Length of Stay, Male, Meningitis, Pneumococcal, Meningitis, Viral, Retrospective Studies, Spinal Puncture, Meningitis, Bacterial, Roseolovirus Infections, Encephalitis, Herpes Simplex, Real-Time Polymerase Chain Reaction
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