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Applications for Open Source Microplate-Compatible Illumination Panels
Published on: October 3, 2019
Association of the FilmArray Meningitis/Encephalitis Panel With Clinical Management
Aleisha M Nabower1, Sydney Miller2, Benjamin Biewen3
1Department of Pediatrics and aleisha.nabower@unmc.edu.
Objectives:
To determine the association of the use of the multiplex assay meningitis/encephalitis panel with clinical management of suspected meningitis.
Methods:
A cross-sectional study was conducted with children 0 to 18 years of age who received a lumbar puncture within 48 hours of admission for an infectious workup. Patient demographic and presenting information, laboratory studies, and medication administration were collected. The primary measure was length of stay (LOS) with secondary measures: time on antibiotics, time to narrowing antibiotics, and acyclovir doses. LOS and antibiotic times were stratified for outcomes occurring before 36 hours. Logistic regression analysis was used to account for potential confounding factors associated with both the primary and secondary outcomes. A value of P < .05 was considered statistically significant.
Results:
Meningitis panel use was associated with a higher likelihood of a patient LOS <36 hours (P = .04; odds ratio = 1.7; 95% confidence interval [CI]: 1.03-2.87), a time to narrowing antibiotics <36 hours (P = .008; odds ratio = 1.89; 95% CI: 1.18-2.87), and doses of acyclovir (P < .001; incidence rate ratio = 0.37; 95% CI: 0.26-0.53). When controlling for potential confounding factors, these associations persisted.
Conclusions:
Use of the meningitis panel was associated with a decreased LOS, time to narrowing of antibiotics, and fewer acyclovir doses. This likely is a result of the rapid turnaround time as compared with cerebrospinal fluid cultures. Additional studies to examine the outcomes related to this change in management are warranted.
Insights
The multiplex meningitis/encephalitis panel significantly reduced hospital length of stay and time to antibiotic adjustment in children. This rapid diagnostic tool also decreased acyclovir use, improving clinical management of suspected meningitis.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
- Diagnostic Assay Development
Background:
- Meningitis and encephalitis are serious infections requiring prompt diagnosis and management.
- Traditional diagnostic methods, like cerebrospinal fluid cultures, have lengthy turnaround times.
- Multiplex assays offer the potential for faster pathogen identification.
Purpose of the Study:
- To evaluate the impact of a multiplex meningitis/encephalitis panel on clinical management of suspected meningitis in children.
- To assess associations between panel use and key clinical outcomes.
Main Methods:
- A cross-sectional study of children (0-18 years) with suspected meningitis.
- Collected data on demographics, clinical presentation, laboratory results, and medication use.
- Analyzed length of stay (LOS), time on antibiotics, time to antibiotic narrowing, and acyclovir doses.
- Used logistic regression to control for confounding factors.
Main Results:
- Multiplex panel use was linked to a shorter LOS (<36 hours) and faster antibiotic narrowing (<36 hours).
- Panel use also correlated with reduced acyclovir dosing.
- These associations remained significant after adjusting for confounding variables.
Conclusions:
- The meningitis/encephalitis multiplex panel is associated with improved clinical management, including reduced LOS and antibiotic duration.
- Rapid turnaround time of the multiplex assay likely drives these positive outcomes compared to traditional cultures.
- Further research is recommended to explore the long-term outcomes of this diagnostic approach.
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