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Clinical utility of polymerase chain reaction testing for enteroviral meningitis

M S Hamilton1, M A Jackson, D Abel

  • 1Department of Pathology, The Children's Mercy Hospital, Kansas City, MO, USA.

The Pediatric Infectious Disease Journal
|July 3, 1999
PubMed
Abstract

Insights

Polymerase chain reaction (PCR) testing for enteroviral meningitis in children significantly reduced hospital stays. This diagnostic approach, despite daily testing costs, proved cost-effective by shortening patient hospitalizations.

Area of Science:

  • Pediatric Infectious Diseases
  • Molecular Diagnostics

Background:

  • Enteroviral meningitis is a common cause of febrile illness in children during summer.
  • Current diagnostic approaches often lead to prolonged hospitalizations for suspected bacterial infections.
  • Rapid diagnostic tools like PCR could potentially reduce healthcare costs.

Purpose of the Study:

  • To evaluate the clinical utility and cost-effectiveness of polymerase chain reaction (PCR) testing for enteroviral meningitis in children.
  • To compare hospitalization length and charges with and without timely PCR results.
  • To assess the impact of daily PCR assay availability on clinical decision-making.

Main Methods:

  • A prospective study comparing two summer seasons of PCR assay use for enteroviral meningitis.
  • Analysis of patient length of stay and hospital charges.
  • Comparison between patients with positive PCR results and case controls with presumed viral infections.
  • Cost analysis per identified case, considering pleocytosis as a screening method.

Main Results:

  • In the second summer, only 10.2% of children with positive enteroviral PCR results were hospitalized for more than 2 days, compared to 37.9% of controls.
  • Mean hospitalization length was significantly shorter for patients with positive PCR results (P < 0.05).
  • The material cost per identified case was approximately $238.

Conclusions:

  • Polymerase chain reaction (PCR) testing demonstrates significant clinical utility in diagnosing enteroviral meningitis.
  • Daily PCR testing, while demanding, is cost-effective due to reduced hospitalization durations.
  • Implementing rapid PCR diagnostics can lead to substantial healthcare cost savings.

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