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Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment

BACKGROUND: Herpes simplex virus–1 is the most common cause of sporadic encephalitis worldwide and requires prompt antiviral treatment. Traditionally, herpes simplex virus–1 (HSV-1) cerebrospinal fluid (CSF) testing is conducted using standalone polymerase chain reaction (PCR). The BioFire CSF FilmA...

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Autores principales: Clague, Madison, Kim, Carla, Zucker, Jason, Green, Daniel A, Sun, Yifei, Whittier, Susan, Thakur, Kiran T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350616/
https://www.ncbi.nlm.nih.gov/pubmed/35937646
http://dx.doi.org/10.1093/ofid/ofac356
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author Clague, Madison
Kim, Carla
Zucker, Jason
Green, Daniel A
Sun, Yifei
Whittier, Susan
Thakur, Kiran T
author_facet Clague, Madison
Kim, Carla
Zucker, Jason
Green, Daniel A
Sun, Yifei
Whittier, Susan
Thakur, Kiran T
author_sort Clague, Madison
collection PubMed
description BACKGROUND: Herpes simplex virus–1 is the most common cause of sporadic encephalitis worldwide and requires prompt antiviral treatment. Traditionally, herpes simplex virus–1 (HSV-1) cerebrospinal fluid (CSF) testing is conducted using standalone polymerase chain reaction (PCR). The BioFire CSF FilmArray Meningitis/Encephalitis Panel (BioFire ME Panel) was introduced in 2015 at our institution, providing an alternative method of HSV-1 CSF testing. This study assesses the impact of the BioFire ME Panel on duration of intravenous acyclovir treatment. METHODS: A retrospective review of electronic medical records between 2010 and 2019 was performed. Information on intravenous acyclovir treatment and HSV-1 CSF testing was collected and analyzed. Our descriptive analysis included Mann-Whitney tests, 2 proportion Z-tests, and logistic regression. RESULTS: Our CSF HSV-1-negative cohort included 524 BioFire patients (125 pediatric, 399 adult) and 287 standalone PCR patients (115 pediatric, 172 adult). Across both pediatric and adult groups, patients who were tested for HSV-1 with the BioFire ME Panel had shorter average (SD) durations of intravenous acyclovir treatment (pediatric: 2.00 [5.71] days; adult: 3.26 [6.59] days) compared with patients tested with standalone PCR (pediatric: 4.83 [8.62] days; adult: 4.93 [8.46] days; P < .001). Time from lumbar puncture collection to HSV-1 results was additionally faster on average for the BioFire ME Panel than the standalone PCR (P < .001). CONCLUSIONS: The implementation of the BioFire ME Panel shortened CSF HSV-1 PCR result time and intravenous acyclovir duration. The shortened treatment and testing times from the BioFire ME Panel implementation may reduce hospital treatment costs and unnecessary use of antiviral treatments.
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spelling pubmed-93506162022-08-05 Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment Clague, Madison Kim, Carla Zucker, Jason Green, Daniel A Sun, Yifei Whittier, Susan Thakur, Kiran T Open Forum Infect Dis Major Article BACKGROUND: Herpes simplex virus–1 is the most common cause of sporadic encephalitis worldwide and requires prompt antiviral treatment. Traditionally, herpes simplex virus–1 (HSV-1) cerebrospinal fluid (CSF) testing is conducted using standalone polymerase chain reaction (PCR). The BioFire CSF FilmArray Meningitis/Encephalitis Panel (BioFire ME Panel) was introduced in 2015 at our institution, providing an alternative method of HSV-1 CSF testing. This study assesses the impact of the BioFire ME Panel on duration of intravenous acyclovir treatment. METHODS: A retrospective review of electronic medical records between 2010 and 2019 was performed. Information on intravenous acyclovir treatment and HSV-1 CSF testing was collected and analyzed. Our descriptive analysis included Mann-Whitney tests, 2 proportion Z-tests, and logistic regression. RESULTS: Our CSF HSV-1-negative cohort included 524 BioFire patients (125 pediatric, 399 adult) and 287 standalone PCR patients (115 pediatric, 172 adult). Across both pediatric and adult groups, patients who were tested for HSV-1 with the BioFire ME Panel had shorter average (SD) durations of intravenous acyclovir treatment (pediatric: 2.00 [5.71] days; adult: 3.26 [6.59] days) compared with patients tested with standalone PCR (pediatric: 4.83 [8.62] days; adult: 4.93 [8.46] days; P < .001). Time from lumbar puncture collection to HSV-1 results was additionally faster on average for the BioFire ME Panel than the standalone PCR (P < .001). CONCLUSIONS: The implementation of the BioFire ME Panel shortened CSF HSV-1 PCR result time and intravenous acyclovir duration. The shortened treatment and testing times from the BioFire ME Panel implementation may reduce hospital treatment costs and unnecessary use of antiviral treatments. Oxford University Press 2022-07-22 /pmc/articles/PMC9350616/ /pubmed/35937646 http://dx.doi.org/10.1093/ofid/ofac356 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Clague, Madison
Kim, Carla
Zucker, Jason
Green, Daniel A
Sun, Yifei
Whittier, Susan
Thakur, Kiran T
Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
title Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
title_full Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
title_fullStr Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
title_full_unstemmed Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
title_short Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment
title_sort impact of implementing the cerebrospinal fluid filmarray meningitis/encephalitis panel on duration of intravenous acyclovir treatment
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350616/
https://www.ncbi.nlm.nih.gov/pubmed/35937646
http://dx.doi.org/10.1093/ofid/ofac356
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