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Impact of FilmArray meningitis encephalitis panel on HSV testing and empiric acyclovir use in children beyond the

Kevin Messacar1, James T Gaensbauer1, Meghan Birkholz2

  • 1University of Colorado School of Medicine Aurora, CO USA; Children's Hospital Colorado Aurora, CO USA.

Diagnostic Microbiology and Infectious Disease
|June 20, 2020
PubMed

Insights

The FilmArray meningitis and encephalitis panel (MEP) doubled herpes simplex virus (HSV) testing in children with suspected central nervous system infections. While acyclovir initiation remained stable, its duration decreased, highlighting the need for stewardship.

Area of Science:

  • Clinical microbiology
  • Infectious diseases
  • Pediatric neurology

Background:

  • Central nervous system infections in children require rapid and accurate diagnosis.
  • The FilmArray meningitis and encephalitis panel (MEP) offers syndromic testing of cerebrospinal fluid (CSF).
  • Herpes simplex virus (HSV) is a significant cause of encephalitis in pediatric populations.

Purpose of the Study:

  • To evaluate the impact of implementing the FilmArray MEP on HSV testing practices.
  • To assess changes in acyclovir prescribing patterns following MEP implementation.
  • To identify opportunities for diagnostic and antimicrobial stewardship in pediatric CNS infections.

Main Methods:

  • Retrospective analysis of pediatric patients with suspected CNS infections.
  • Comparison of HSV testing rates before and after MEP panel implementation.
  • Analysis of acyclovir initiation and duration of therapy.

Main Results:

  • HSV testing in children over 60 days with suspected CNS infection doubled post-MEP implementation.
  • Acyclovir initiation rates remained unchanged.
  • The duration of acyclovir therapy decreased following MEP implementation.

Conclusions:

  • Rapid syndromic testing with the FilmArray MEP significantly increased HSV diagnostic utilization.
  • While acyclovir initiation was not affected, treatment duration was reduced, suggesting potential for antimicrobial stewardship.
  • Optimizing MEP utilization requires ongoing attention to diagnostic stewardship and appropriate antiviral prescribing.

Keywords:
AcyclovirAntimicrobial stewardshipDiagnostic stewardshipDiagnosticsEncephalitisHerpesMeningitisPediatrics

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