ArticleThe Journal of pediatrics2022
Clinical and Financial Impact of a Diagnostic Stewardship Program for Children with Suspected Central Nervous System Infection.
Article in The Journal of pediatrics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 28 citations in OpenAlex.
- Antibiotic use in children with suspected CNS infection in the molecular diagnostic era: a cohort study of 1198 children.JAC-antimicrobial resistance · 2026Article
- Enhancing meningitis diagnosis: a diagnostic stewardship workflow in a resource-limited setting.Microbiology spectrum · 2026Article
- Clinical and Laboratory Profiles, Time to Presentation, and Antibacterial Therapy in Children with Aseptic Meningitis: A Comparison of Confirmed Enteroviral and Unidentified-Etiology Cases.Epidemiologia (Basel, Switzerland) · 2026Article
- Review
- Diagnosis of Respiratory Infections Using Syndromic Panels: A Ct-Based Approach Beyond Qualitative Detection.Microorganisms · 2026Article
- Faster Results, Better Care? Impact of Meningitis/Encephalitis Syndromic Panel Testing on Pathogen Detection and Hospital Outcomes Beyond CSF Culture: A Literature Search for Diagnosticians.Diagnostics (Basel, Switzerland) · 2026Review
- Diagnostic Innovations to Combat Antibiotic Resistance in Critical Care: Tools for Targeted Therapy and Stewardship.Diagnostics (Basel, Switzerland) · 2025Review
- The clinical impact of herpesvirus testing on multiplex PCR panels in a pediatric population.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- The foundation for the microbiology laboratory's essential role in diagnostic stewardship: an ASM Laboratory Practices Subcommittee report.Journal of clinical microbiology · 2024Review
- Comment on Cuesta et al. An Assessment of a New Rapid Multiplex PCR Assay for the Diagnosis of Meningoencephalitis.Diagnostics (Basel, Switzerland) · 2024Article
- Diagnostic stewardship in infectious diseases: a scoping review.Journal of medical microbiology · 2024Article
- A decade of clinical microbiology: top 10 advances in 10 years: what every infection preventionist and antimicrobial steward should know.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Review
- Impact of Multiplex Polymerase Chain Reaction Test in Patients With Meningitis or Encephalitis.Open forum infectious diseases · 2023Article
- Evaluation of the Novel CE-IVD-Marked Multiplex PCR QIAstat-Dx Meningitis/Encephalitis Panel.Microbiology spectrum · 2023Article
- Current state and practice variation in the use of Meningitis/Encephalitis (ME) FilmArray panel in children.BMC infectious diseases · 2022Article
- Opportunities for Antimicrobial Stewardship in Caring for Febrile Pediatric Inpatients in Abu Dhabi.Global pediatric health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo investigate the optimal implementation and clinical and financial impacts of the FilmArray Meningitis Encephalitis Panel (MEP) multiplex polymerase chain reaction testing of cerebrospinal fluid (CSF) in children with suspected central nervous system infection. STUDY
designA pre-post quasiexperimental cohort study to investigate the impact of implementing MEP using a rapid CSF diagnostic stewardship program was conducted at Children's Hospital Colorado (CHCO). MEP was implemented with electronic medical record indication selection to guide testing to children meeting approved use criteria: infants <2 months, immunocompromised, encephalitis, and ≥5 white blood cells/μL of CSF. Positive results were communicated with antimicrobial stewardship real-time decision support. All cases with CSF obtained by lumbar puncture sent to the CHCO microbiology laboratory meeting any of the 4 aforementioned criteria were included with preimplementation controls (2015-2016) compared with postimplementation cases (2017-2018). Primary outcome was time-to-optimal antimicrobials compared using log-rank test with Kaplan-Meier analysis.
resultsTime-to-optimal antimicrobials decreased from 28 hours among 1124 preimplementation controls to 18 hours (P < .0001) among 1127 postimplementation cases (72% with MEP testing conducted). Postimplementation, time-to-positive CSF results was faster (4.8 vs 9.6 hours, P < .0001), intravenous antimicrobial duration was shorter (24 vs 36 hours, P = .004), with infectious neurologic diagnoses more frequently identified (15% vs 10%, P = .03). There were no differences in time-to-effective antimicrobials, hospital admissions, antimicrobial starts, or length of stay. Costs of microbiologic testing increased, but total hospital costs were unchanged.
conclusionsImplementation of MEP with a rapid central nervous system diagnostic stewardship program improved antimicrobial use with faster results shortening empiric therapy. Routine MEP testing for high-yield indications enables antimicrobial optimization with unchanged overall costs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.