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Infection

, Volume 47, Issue 1, pp 51–58 | Cite as

Clinical benefits of introducing real-time multiplex PCR for cerebrospinal fluid as routine diagnostic at a tertiary care pediatric center

  • Anna Eichinger
  • Alexandra Hagen
  • Melanie Meyer-Bühn
  • Johannes HuebnerEmail author
Original Paper

Abstract

Background

Sepsis-like illness with suspected meningitis or encephalitis is a common reason for using empiric antimicrobial therapy in infants and children. However, in cases of viral meningitis not covered by these antimicrobials, this management is ineffective and due to side effects potentially harmful.

Methods

A retrospective analysis of cerebrospinal fluid (CSF) multiplex PCRs (Biofire FilmArray®) in children with clinical suspicion of meningitis, encephalitis or sepsis-like illness was performed over the period of 1 year. Subsequently, a subgroup of children (age of 8–84 days of life) diagnosed with viral meningitis (enterovirus, HHV-6, human parechovirus) was compared to an age-matched control group.

Results

During the study period, the multiplex PCR panel was performed on 187 individual CSF samples that met the inclusion criteria. About half of the patients (92/187) were less than 1 year of age. In 27 cases (14.4%), the PCR yielded a positive result with the majority (12/27) being indicative of an enteroviral infection. In the age group of 8–84 days of life, 36.4% of the patients had a positive result. When the patients with a PCR positive for a viral agent were compared to an age-matched group of patients, no differences were observed regarding symptoms and laboratory parameters. However, the duration of antimicrobial therapy could be significantly reduced through the use of multiplex PCR.

Conclusion

The use of on-site diagnostic multiplex PCR was able to reduce the use of antimicrobials in selected cases. This test can guide clinical decisions earlier during the course of medical care compared to standard diagnostics.

Keywords

Antimicrobial stewardship Point-of-care test FilmArray Meningitis Encephalitis 

Notes

Compliance with ethical standards

Conflict of interest

JH has received speaker fees and MMB has been invited to a seminar by BioMerieux, and the other authors declare that they have no conflict of interest.

Supplementary material

15010_2018_1212_MOESM1_ESM.pdf (111 kb)
Supplementary material 1 (PDF 111 KB)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Anna Eichinger
    • 1
  • Alexandra Hagen
    • 1
  • Melanie Meyer-Bühn
    • 1
  • Johannes Huebner
    • 1
    Email author
  1. 1.Division of Pediatric Infectious Disease, Dr. v. Hauner Children’s Hospital, LMU MunichUniversity of Munich (LMU)MunichGermany

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