RT Journal
A1 Dewan M, Zorc JJ, Hodinka RL, Shah SS
T1 CErebrospinal fluid enterovirus testing in infants 56 days or younger
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2010
FD September 1
VO 164
IS 9
SP 824
OP 830
DO 10.1001/archpediatrics.2010.153
UL http://dx.doi.org/10.1001/archpediatrics.2010.153
AB Objective 
    To determine whether cerebrospinal fluid (CSF) enterovirus polymerase chain reaction (PCR) testing of febrile neonates is associated with a shorter hospital length of stay (LOS).Design 
    Retrospective cohort study.Setting 
    Urban tertiary care children's hospital emergency department.Participants 
    Febrile infants 56 days or younger evaluated by means of lumbar puncture.Main Exposure 
    Performance of CSF enterovirus PCR testing.Main Outcome Measure 
    Hospital LOS.Results 
    A CSF enterovirus PCR test was performed in 361 of 1231 eligible infants (29.3%); 89 of those tested (24.7%) were positive. The median LOS was 2 days. In multivariable analysis, CSF enterovirus PCR testing was associated with a 26.0% shorter LOS for infants with a positive test result (adjusted β coefficient, −0.305; 95% confidence interval, −0.457 to −0.153; P < .001) and an 8.0% longer LOS for those with a negative test result (0.075; −0.021 to 0.171; P = .12) compared with untested infants. In stratified analysis, LOS was shorter for all infants 28 days or younger who tested positive regardless of receipt of antibiotics before lumbar puncture. For infants 29 to 56 days old, a positive test result was associated with a shorter LOS only in those not previously receiving antibiotics. The median (interquartile range) turnaround time for CSF enterovirus PCR testing was 22.2 (15.1-27.4) hours, with no effect of turnaround time on LOS.Conclusions 
    Among infants 56 days or younger, a positive CSF enterovirus PCR test result was associated with a shorter LOS compared with untested infants. The CSF enterovirus PCR test may improve the care of infants with fever.