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引入一种基于聚合酶链反应检测板的新型脑脊液评估方法用于脑炎和脑膜炎:它是否会影响经验性治疗持续时间、住院时间和病原体特异性诊断?

Introducing a New Polymerase Chain Reaction Panel-Based Cerebrospinal Fluid Evaluation for Encephalitis and Meningitis: Does It Influence Empiric Treatment Duration, Length of Hospital Stay, and Pathogen-Specific Diagnoses?

作者信息

Sidler Fabian, Bittel Pascal, Marschall Jonas, Jent Philipp

机构信息

Department of Visceral Surgery and Medicine, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland.

Institute for Infectious Diseases, University of Bern, Bern, Switzerland.

出版信息

Open Forum Infect Dis. 2025 Apr 24;12(5):ofaf241. doi: 10.1093/ofid/ofaf241. eCollection 2025 May.

DOI:10.1093/ofid/ofaf241
PMID:40322268
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12048797/
Abstract

We analyzed the impact of a diagnostic meningitis/encephalitis polymerase chain reaction panel. Introducing the test resulted in no significantly shortened empiric antibiotic streptococcal/meningococcal treatment (-1 day [95% confidence interval {CI}, 0-3 days]; = .16), nor hospitalization (-2 days [95% CI, 0-3 days]; = .86). Empiric treatment duration against Herpesviridae and remained unchanged, and pathogen-specific diagnoses were not increased.

摘要

我们分析了诊断性脑膜炎/脑炎聚合酶链反应检测板的影响。引入该检测并未显著缩短经验性抗生素治疗链球菌/脑膜炎球菌感染的疗程(缩短1天[95%置信区间{CI},0 - 3天];P = 0.16),也未缩短住院时间(缩短2天[95%CI,0 - 3天];P = 0.86)。针对疱疹病毒科的经验性治疗疗程保持不变,且病原体特异性诊断并未增加。

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本文引用的文献

1
Impact of Implementing the Cerebrospinal Fluid FilmArray Meningitis/Encephalitis Panel on Duration of Intravenous Acyclovir Treatment.实施脑脊液FilmArray脑膜炎/脑炎检测板对静脉注射阿昔洛韦治疗疗程的影响
Open Forum Infect Dis. 2022 Jul 22;9(8):ofac356. doi: 10.1093/ofid/ofac356. eCollection 2022 Aug.
2
Cerebrospinal Fluid Analysis With the BioFire FilmArray Meningitis/Encephalitis Molecular Panel Reduces Length of Hospital Stay in Patients With Suspected Central Nervous System Infections.使用BioFire FilmArray脑膜炎/脑炎分子检测板进行脑脊液分析可缩短疑似中枢神经系统感染患者的住院时间。
Open Forum Infect Dis. 2019 Mar 5;6(4):ofz119. doi: 10.1093/ofid/ofz119. eCollection 2019 Apr.
3
Contribution of the BioFire FilmArray Meningitis/Encephalitis Panel: Assessing Antimicrobial Duration and Length of Stay.
BioFire FilmArray脑膜炎/脑炎检测板的作用:评估抗菌药物使用时长和住院时间
Kans J Med. 2019 Feb 26;12(1):1-3. eCollection 2019 Feb.
4
Diagnostic Stewardship: Opportunity for a Laboratory-Infectious Diseases Partnership.诊断管理:实验室-传染病学合作的机会。
Clin Infect Dis. 2018 Aug 16;67(5):799-801. doi: 10.1093/cid/ciy077.
5
A Tertiary Care Center's Experience with Novel Molecular Meningitis/Encephalitis Diagnostics and Implementation with Antimicrobial Stewardship.一家三级医疗中心在新型分子性脑膜炎/脑炎诊断及抗菌药物管理实施方面的经验
Mil Med. 2018 Jan 1;183(1-2):e24-e27. doi: 10.1093/milmed/usx025.
6
ESCMID guideline: diagnosis and treatment of acute bacterial meningitis.欧洲临床微生物学与感染病学会指南:急性细菌性脑膜炎的诊断与治疗
Clin Microbiol Infect. 2016 May;22 Suppl 3:S37-62. doi: 10.1016/j.cmi.2016.01.007. Epub 2016 Apr 7.
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Combination of ceftriaxone and acyclovir - an underestimated nephrotoxic potential?头孢曲松与阿昔洛韦联用——肾毒性潜力是否被低估?
Pediatr Nephrol. 2002 Aug;17(8):633-7. doi: 10.1007/s00467-002-0867-5. Epub 2002 May 17.