Methods: A retrospective review of data from MEP processed by Health Network Laboratories in children ≤18 years of age, from February 1st, 2016 to December 31st, 2017, at Lehigh Valley Children’s Hospital.
Results: A total of 220 MEP results were included in the study, with 46 positive samples. Of the positive samples, 5 were positive for bacterial organisms, 4 E. coli and 1 N. meningitidis. Four of the corresponding CSF cultures grew E. coli. The CSF culture corresponding to the MEP positive for N. meninigitidis, was negative, but both samples were collected after 1 dose of ceftriaxone. Of the positive MEPs, 89% were positive for a viral pathogen, with 3 samples positive for Herpes Simplex Virus (HSV). MEPs had a lower average turnaround time of 6.9 hours when compared to CSF cultures of 48.8 hours. Average LOS was 5.7 days for those with a negative MEP compared to 3.8 days for those with a positive viral MEP other than HSV. Empiric antiviral treatment with acyclovir was initiated in 58 patients; patients with a negative MEP for HSV received an average of 3.13 doses.
Conclusion: The study showed 100% concordance between MEP and CSF culture for E. coli meningitis. The discordance between CSF culture and MEP corresponding to N. meningitidis indicates that the increased sensitivity of MEP may play a role in the management of partially treated meningitis. The use of the BioFire MEP may be helpful in decreasing the average LOS in patients where a viral etiology other than HSV is identified. Faster turnaround time of MEP may decrease the number of antiviral doses in those with a negative MEP for HSV.