Screening for enteroviral meningitis in infants and children-Is it useful in clinical practice?

Area of Science:

• Pediatrics
• Infectious Diseases
• Clinical Diagnostics

Background:

• Enteroviral meningitis is a common cause of hospital admission in infants and children.
• Clinical diagnosis of viral meningitis can be difficult, impacting patient management.
• Accurate and timely diagnosis is crucial for appropriate treatment and resource allocation.

Purpose of the Study:

• To evaluate the clinical utility of enteroviral polymerase chain reaction (PCR) testing on cerebrospinal fluid (CSF) samples.
• To compare clinical outcomes and laboratory parameters between children with positive and negative enteroviral CSF PCR results.
• To assess the impact of PCR testing on patient management and healthcare resource utilization.

Main Methods:

• Retrospective analysis of clinical data from infants and children diagnosed with meningitis.
• Comparison of clinical outcomes (e.g., high dependency unit admission, antibiotic duration, length of stay) between PCR-positive and PCR-negative groups.
• Evaluation of laboratory parameters, including CSF white cell count, in relation to PCR results.

Main Results:

• A positive enteroviral CSF PCR result correlated with reduced high dependency unit admission, shorter antibiotic duration, and decreased length of hospital stay (P < .05).
• An adjusted CSF white cell count threshold of >5/μL showed correlation with positive PCR (P < .05) but would have missed 32% of enteroviral meningitis cases.
• The study demonstrated the significant impact of PCR testing on clinical decision-making and patient outcomes.

Conclusions:

• Enteroviral PCR testing of CSF is a valuable tool in the management of suspected viral meningitis in children.
• Implementing PCR testing can lead to more efficient patient management, including reduced antibiotic use and shorter hospitalizations.
• The findings support the introduction of an algorithm for managing suspected viral meningitis based on PCR results.