Related Experiment Video
Updated: Aug 26, 2025
Intracerebroventricular and Intravascular Injection of Viral Particles and Fluorescent Microbeads into the Neonatal Brain
Published on: July 24, 2016
Impact of CSF Meningitis and Encephalitis Panel on Resource Use for Febrile Well-Appearing Infants
Angelica W DesPain1, Ryan Pearman2, Rana F Hamdy3,4
1Division of Emergency Medicine, The Children's Hospital of San Antonio, San Antonio, Texas.
Objectives:
To determine whether the BioFire FilmArray Meningitis/Encephalitis (ME) panel is associated with decreased resource use for febrile infants. The ME panel has a rapid turnaround time (1-2 hours) and may shorten length of stay (LOS) and antimicrobial use for febrile well-appearing infants.
Methods:
Retrospective cohort study of febrile well-appearing infants ≤60 days with cerebrospinal fluid culture sent in the emergency department from July 2017 to April 2019. We examined the frequency of ME panel use and its relationship with hospital LOS and initiation and duration of antibiotics and acyclovir. We used nonparametric tests to compare median durations.
Results:
The ME panel was performed for 85 (36%) of 237 infants. There was no difference in median hospital LOS for infants with versus without ME panel testing (42 hours, interquartile range [IQR] 36-52 vs 40 hours, IQR: 35-47, P = .09). More than 97% of infants with and without ME panel testing were initiated on antibiotics. Patients with ME panel were more likely to receive acyclovir (33% vs 18%; odds ratio: 2.2, 95%: confidence interval 1.2-4.0). There was no difference in median acyclovir duration with or without ME panel testing (1 hour, IQR: 1-7 vs 4.2 hours, IQR: 1-21, P = .10). When adjusting for potential covariates, these findings persisted.
Conclusions:
ME panel use was not associated with differences in hospital LOS, antibiotic initiation, or acyclovir duration in febrile well-appearing infants. ME panel testing was associated with acyclovir initiation.
Insights
The BioFire FilmArray Meningitis/Encephalitis (ME) panel did not reduce hospital length of stay or antibiotic use in febrile infants. However, ME panel testing was linked to increased acyclovir initiation in this patient group.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Diagnostics
- Healthcare Resource Utilization
Background:
- Febrile infants require prompt diagnosis to rule out serious infections like meningitis and encephalitis.
- The BioFire FilmArray Meningitis/Encephalitis (ME) panel offers rapid results (1-2 hours) for pathogen identification.
- Potential benefits include reduced length of stay (LOS) and antimicrobial use.
Purpose of the Study:
- To evaluate the association between BioFire FilmArray ME panel use and resource utilization in febrile infants.
- To determine if ME panel testing impacts hospital LOS, antibiotic duration, or acyclovir use.
Main Methods:
- Retrospective cohort study of febrile infants (≤60 days) from July 2017 to April 2019.
- Examined ME panel use, hospital LOS, and antibiotic/antiviral initiation and duration.
- Nonparametric tests used for median duration comparisons.
Main Results:
- ME panel was used in 36% of 237 infants.
- No significant difference in median hospital LOS between ME panel and non-ME panel groups (40-42 hours).
- Antibiotic initiation was high (>97%) in both groups; ME panel use was associated with increased acyclovir initiation (33% vs 18%) but not duration.
Conclusions:
- BioFire FilmArray ME panel use was not associated with reduced hospital LOS or antibiotic use in febrile infants.
- ME panel testing was associated with increased initiation of acyclovir.
- Further research may be needed to optimize the clinical utility of the ME panel in febrile infants.
