期刊
JOURNAL OF CLINICAL VIROLOGY
卷 62, 期 -, 页码 58-62出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jcv.2014.11.001
关键词
Enterovirus; Meningitis; PCR; CSF; Management; Rapid
类别
资金
- Quality Control Program of the Lausanne University Hospital [127]
- Foundation for the Advancement in Medical Microbiology and Infectious Diseases (FAMMID), Lausanne, Switzerland
Background: Enterovirus (EV) is the most frequent cause of aseptic meningitis (AM). Lack of microbiological documentation results in unnecessary antimicrobial therapy and hospitalization. Objectives: To assess the impact of rapid EV detection in cerebrospinal fluid (CSF) by a fully-automated PCR (GeneXpert EV assay, GXEA) on the management of AM. Study design: Observational study in adult patients with AM. Three groups were analyzed according to EV documentation in CSF: group A = no PCR or negative PCR (n = 17), group B = positive real-time PCR (n = 20), and group C = positive GXEA (n = 22). Clinical, laboratory and health-care costs data were compared. Results: Clinical characteristics were similar in the 3 groups. Median turn-around time of EV PCR decreased from 60 h (IQR (interquartile range) 44-87) in group B to 5 h (IQR 4-11) in group C (p < 0.0001). Median duration of antibiotics was 1 (IQR 0-6), 1 (0-1.9), and 0.5 days (single dose) in groups A, B, and C, respectively (p < 0.001). Median length of hospitalization was 4 days (2.5-7.5), 2 (1-3.7), and 0.5 (0.3-0.7), respectively (p < 0.001). Median hospitalization costs were $5458 (2676-6274) in group A, $2796 (2062-5726) in group B, and $921 (765-1230) in group C (p < 0.0001). Conclusions: Rapid EV detection in CSF by a fully-automated PCR improves management of AM by significantly reducing antibiotic use, hospitalization length and costs. (C) 2014 Elsevier B.V. All rights reserved.
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