Retrospective Evaluation of Infants Aged 1 to 60 Days with Residual Cerebrospinal Fluid (CSF) Tested Using the FilmArray Meningitis/Encephalitis (ME) Panel.

Autor:	Blaschke AJ; University of Utah School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, Salt Lake City, Utah, USA anne.blaschke@hsc.utah.edu., Holmberg KM; BioFire Diagnostics, LLC, Salt Lake City, Utah, USA., Daly JA; Primary Children's Hospital, Salt Lake City, Utah, USA., Leber AL; Nationwide Children's Hospital, Columbus, Oklahoma, USA., Dien Bard J; Children's Hospital of Los Angeles, Los Angeles, California, USA., Korgenski EK; University of Utah School of Medicine, Department of Pediatrics, Division of Pediatric Infectious Diseases, Salt Lake City, Utah, USA.; Pediatric Clinical Program, Intermountain Healthcare, Salt Lake City, Utah, USA., Bourzac KM; BioFire Diagnostics, LLC, Salt Lake City, Utah, USA., Kanack KJ; BioFire Diagnostics, LLC, Salt Lake City, Utah, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical microbiology [J Clin Microbiol] 2018 Jun 25; Vol. 56 (7). Date of Electronic Publication: 2018 Jun 25 (Print Publication: 2018).
DOI:	10.1128/JCM.00277-18
Abstrakt:	In pediatric practice it is common for infants under 2 months of age to undergo evaluation for sepsis when they are ill, often including lumbar puncture to assess for central nervous system (CNS) infection. The FilmArray Meningitis/Encephalitis (ME) panel is a newly approved test for rapid identification of CNS pathogens. Our objective was to study the epidemiology of CNS infection in young infants and the potential impact of rapid multiplex PCR on their care. A performance evaluation of the FilmArray ME panel was conducted from February 2014 to September 2014 at 11 sites. FilmArray ME panel results were compared to reference standards but not shared with providers. In our study, medical records for infants (aged 1 to 60 days) enrolled at three sites were reviewed for clinical, laboratory, and outcome data. A total of 145 infants were reviewed. The median age was 25 days. Most of the infants were hospitalized (134/145 [92%]) and received antibiotics (123/145 [85%]), and almost half (71/145 [49%]) received acyclovir. One infant had a bacterial pathogen, likely false positive, identified by the FilmArray ME panel. Thirty-six infants (25%) had a viral pathogen detected, including 21 enteroviruses. All infants with enteroviral meningitis detected by the FilmArray ME panel and conventional PCR were hospitalized, but 20% were discharged in less than 24 h when conventional PCR results became available. The FilmArray ME panel may play a role in the evaluation of young infants for CNS infection. Results may be used to guide management, possibly resulting in a decreased length of stay and less antimicrobial exposure for infants with low-risk viral infection detected. (Copyright © 2018 Blaschke et al.)
Databáze:	MEDLINE
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