Evaluating the Impact of the BioFire FilmArray in Childhood Meningitis: An Observational Cohort Study.

Autor:	Kadambari S; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom.; Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust.; Infection, Immunity and Inflammation department, University College London, Great Ormond Street Institute of Child Health, London, United Kingdom., Feng S; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom., Liu X; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom., Andersson M; Department of Microbiology, Oxford University Hospitals NHS Foundation Trust.; NDCLS, Radcliffe Department of Medicine., Waterfield R; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom., Fodder H; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom., Jacquemot A; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom., Galal U; Oxford Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom., Rafferty A; Department of Clinical Microbiology.; Department of Pharmacy., Drew RJ; Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street.; Clinical Innovation Unit, Rotunda Hospital.; Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland., Rodrigues C; Department of Paediatric Infectious Diseases, St Mary's Hospital, Imperial College Healthcare NHS Trust.; Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom., Sadarangani M; Vaccine Evaluation Center, BC Children's Hospital Research Institute.; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada., Riordan A; Department of Paediatric Infectious Diseases and Immunology, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom., Martin NG; Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand., Defres S; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom.; Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust.; Department of Clinical Sciences and Education, Liverpool School of Tropical Medicine., Solomon T; The Pandemic Institute.; Department of Clinical Infection, Microbiology, and Immunology (CIMI).; Institute of Infection, Veterinary & Ecological Sciences.; National Institute for Health and Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool.; Walton Centre NHS Foundation Trust, Liverpool, United Kingdom., Pollard AJ; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom., Paulus S; From the Oxford Vaccine Group, Department of Paediatrics, University of Oxford, NIHR Oxford Biomedical Research Centre, Oxford, United Kingdom.
Jazyk:	angličtina
Zdroj:	The Pediatric infectious disease journal [Pediatr Infect Dis J] 2024 Apr 01; Vol. 43 (4), pp. 345-349. Date of Electronic Publication: 2024 Jan 04.
DOI:	10.1097/INF.0000000000004236
Abstrakt:	Background: Multiplex polymerase chain reaction assays have the potential to reduce antibiotic use and shorten length of inpatient stay in children with suspected central nervous system infection by obtaining an early microbiological diagnosis. The clinical impact of the implementation of the BioFire FilmArray Meningitis/Encephalitis Panel on the management of childhood meningitis was evaluated at the John Radcliffe Hospital in Oxford and Children's Health Ireland at Temple Street in Dublin. Methods: Children who had lumbar punctures performed as part of a septic screen were identified retrospectively through clinical discharge coding and microbiology databases from April 2017 to December 2018. Anonymized clinical and laboratory data were collected. Comparison of antibiotic use, length of stay and outcome at discharge was made with a historical cohort in Oxford (2012-2016), presenting before implementation of the FilmArray. Results: The study included 460 children who had a lumbar puncture as part of an evaluation for suspected central nervous system infection. Twelve bacterial cases were identified on the FilmArray that were not detected by conventional bacterial culture. Bacterial culture identified one additional case of bacterial meningitis, caused by Escherichia coli , which had not been identified on the FilmArray. Duration of antibiotics was shorter in children when FilmArray was used than before its implementation; enterovirus meningitis (median: 4 vs. 5 days), human parechovirus meningitis (median: 4 vs. 4.5 days) and culture/FilmArray-negative cerebrospinal fluid (median: 4 vs. 6 days). Conclusions: The use of a FilmArray can identify additional bacterial cases of meningitis in children that had been negative by traditional culture methods. Children with viral meningitis and culture-negative meningitis received shorter courses of antibiotics and had shorter hospital stays when FilmArray was used. Large studies to evaluate the clinical impact and cost effectiveness of incorporating the FilmArray into routine testing are warranted. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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