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Herpes simplex virus testing and hospital length of stay in neonates and young infants

Samir S Shah1, Jessica Volk, Zeinab Mohamad

  • 1Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. shahs@email.chop.edu

The Journal of Pediatrics
|February 13, 2010
PubMed

Insights

Testing cerebrospinal fluid (CSF) for herpes simplex virus (HSV) using polymerase chain reaction (PCR) in infants is linked to longer hospital stays and higher costs. This diagnostic approach significantly impacts resource utilization in pediatric care.

Area of Science:

  • Pediatric Infectious Diseases
  • Diagnostic Testing
  • Healthcare Economics

Background:

  • Herpes simplex virus (HSV) infections can cause serious illness in neonates and young infants.
  • Early diagnosis is crucial for timely treatment and improved outcomes.
  • Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) is a key diagnostic tool for suspected HSV meningitis or encephalitis.

Purpose of the Study:

  • To evaluate the association between CSF HSV PCR testing and hospital length of stay (LOS) in infants.
  • To determine if CSF HSV PCR testing correlates with increased hospital charges in this population.

Main Methods:

  • Retrospective cohort study of infants aged 56 days or younger who underwent lumbar puncture.
  • Analysis of data from 2005-2006, comparing infants who received CSF HSV PCR testing with those who did not.
  • Multivariate analysis to control for potential confounding factors affecting LOS and hospital charges.

Main Results:

  • CSF HSV PCR testing was performed in 31.7% of eligible infants.
  • Testing was associated with a significant increase in LOS (28-39% depending on age group).
  • CSF HSV PCR testing correlated with a 41% increase in hospital charges and a 22% increase in LOS for every 12-hour delay in test turnaround time.

Conclusions:

  • CSF HSV PCR testing in infants evaluated via lumbar puncture is associated with significantly longer hospital stays.
  • The use of CSF HSV PCR testing leads to substantially higher hospital charges.
  • These findings highlight the economic and resource implications of diagnostic strategies for HSV in infants.
Abstract

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