The clinical impact of multiplex PCR panel diagnostics in paediatric meningitis/ encephalitis: a bicenter cohort study.
Purpose: In infections of the Central Nervous System (iCNS), rapid identification of causing pathogens is crucial for survival and to avoid long-term sequelae. Targeted therapy may reduce side effects and development of antibiotic resistance. New molecular-based syndromic tests such as the "meningit...
| Publicado en: | Infection Vol. 50; no. 5; pp. 1329 - 1349 |
|---|---|
| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2022
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=159413652&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159413652 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03008126 NXO jtl: Infection issn: 03008126 maglogo: N pubinfo: dt: Oct2022 vid: 50 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 159413652 157585847 159413652 159413652 10.1007/s15010-022-01836-5 159413652 ppf: 1329 ppct: 20 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The clinical impact of multiplex PCR panel diagnostics in paediatric meningitis/ encephalitis: a bicenter cohort study. aug: au: Disse, Sigrid Claudia Zapf, Antonia Schneble, Fritz Fiedler, Andreas Hossain, Hamid von Meyer, Alexander affil: Children's Hospital Weiden, Kliniken Nordoberpfalz AG, Academic Teaching Hospital University Medical Center Regensburg, Söllnerstraße 16, 92637, Weiden i.d. Oberpfalz, Germany sug: subj: Central Nervous System Infections Diagnosis Central Nervous System Infections Cerebrospinal Fluid Meningitis Diagnosis Encephalitis Diagnosis Polymerase Chain Reaction Methods Human Male Female Infant Child, Preschool Child Adolescence Germany Hospitals, Pediatric Record Review Multicenter Studies Retrospective Design Prospective Studies Virulence Infant: 1-23 months Child, Preschool: 2-5 years Child: 6-12 years Adolescent: 13-18 years Male Female ab: Purpose: In infections of the Central Nervous System (iCNS), rapid identification of causing pathogens is crucial for survival and to avoid long-term sequelae. Targeted therapy may reduce side effects and development of antibiotic resistance. New molecular-based syndromic tests such as the "meningitis/encephalitis panel" (MEP) allow accelerated pathogen identification from cerebrospinal fluid. We conducted a clinical study to evaluate the MEP's efficacy in paediatric patients. Methods: Cohort study in a unique clinical setting by comparing the outcome data of two neighbouring Children's Hospitals in Germany which are comparable in size, catchment area and equipment but differ regarding availability of the MEP: study centre 1 (SC1): yes; SC2: no. The study population included 213 paediatric patients with a suspected iCNS (SC1: 106; SC2: 107), with comparable age, CRP at admission and frequency of intensive care. The primary outcome was total use of antibiotics. Results: Total antibiotic use per patient was numerically lower in SC1 than in SC2 (SC1: median 2.83 days; SC2 3.67 days; p = 0.671). Multiple linear regression analysis did not show a relevant association between MEP-availability and total antibiotic use (ß = 0.1, 95% confidence interval [−1.46; +1.67], p = 0.897). In the subcohort with suspected meningoencephalitis (SC1: 18, SC2: 17), duration of acyclovir treatment was shorter in SC1 than in SC2 (median 1.3 days vs. 2.7 days, descriptive p = 0.0397). Conclusions: The add-on use of the MEP in paediatric patients with suspected iCNS was associated with a non-significant reduction in total antibiotic use, and with a reduced exposure to acyclovir in treated patients. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|