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Burden of Pediatric Central Nervous System Infection and Cost-Benefit Simulation of Multiplex Polymerase Chain
Taito Kitano1,2, Hiroki Nishikawa3, Rika Suzuki3
1Division of Infectious Diseases, The Hospital for Sick Children, Canada.
Abstract:
To investigate the clinical use of multiplex polymerase chain reaction (mPCR) in Japan, epidemiological and clinical data for central nervous infections are needed. Here, we report on the epidemiology and economic burden of central nervous system infections and a simulation of the cost-benefit analysis of the Filmarray® Meningitis/Encephalitis (FAME) test for possible clinical use in Japan. We performed FAME tests on samples from 27 patients with pleocytosis aged between 0 and 20 years seen in six community hospitals in Nara and Osaka prefectures. All clinical management procedures were performed without knowledge of the mPCR test results. We analyzed the clinical data and calculated the required reduction in average length of stay for the FAME test to be cost-beneficial. Among the 27 cases, the FAME test revealed causal pathogens in 13 cases (48.1%). The average medical and social costs per case were ¥299,118 ($2,719.2) and ¥171,768 ($1,561.5), respectively. The minimal needed reduction in average length of stay for the FAME test to be cost-beneficial was 0.32- 0.86 days per meningitis case. The result can be informative for evaluating the cost-effectiveness of the clinical use of the FAME test in Japan.
Insights
Multiplex polymerase chain reaction (mPCR) testing for central nervous system infections in Japan identified pathogens in 48.1% of pediatric cases. A small reduction in hospital stay could make this diagnostic tool cost-beneficial.
Area of Science:
- Clinical microbiology
- Health economics
- Epidemiology
Background:
- Central nervous system infections pose a significant health burden.
- Multiplex polymerase chain reaction (mPCR) offers rapid pathogen identification.
- Clinical utility and cost-effectiveness of mPCR in Japan require evaluation.
Purpose of the Study:
- To assess the epidemiology and economic burden of central nervous system infections in Japan.
- To simulate the cost-benefit analysis of the FilmArray® Meningitis/Encephalitis (FAME) test for clinical use.
- To inform decisions regarding the adoption of mPCR diagnostics in Japanese healthcare.
Main Methods:
- Conducted FAME tests on samples from 27 pediatric patients (0-20 years) with pleocytosis.
- Collected epidemiological and clinical data from six community hospitals in Nara and Osaka prefectures.
- Analyzed clinical data and calculated the necessary length of stay reduction for cost-benefit.
Main Results:
- The FAME test identified causal pathogens in 13 out of 27 cases (48.1%).
- Average medical and social costs per case were ¥299,118 and ¥171,768, respectively.
- A reduction of 0.32-0.86 days in average length of stay per meningitis case is needed for cost-benefit.
Conclusions:
- The FAME test can significantly aid in identifying pathogens causing central nervous system infections.
- The cost-effectiveness of the FAME test in Japan is dependent on achieving a minimal reduction in patient hospitalization duration.
- Findings provide valuable data for healthcare providers and policymakers considering mPCR implementation.
