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J Hosp Med. 2019 Aug 1;14(8):492-495. doi: 10.12788/jhm.3202. Epub 2019 May 12.

Association of Herpes Simplex Virus Testing with Hospital Length of Stay for Infants ≤60 Days of Age Undergoing Evaluation for Meningitis.

Author information

1
Section of Pediatric Emergency Medicine, Departments of Pediatrics and of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut.
2
Sections of Pediatric Emergency Medicine and of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
3
Sections of Pediatric Emergency Medicine and Gastroenterology, Department of Pediatrics, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta.
4
Division of Emergency Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
5
Center for Pediatric Clinical Effectiveness, Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
6
Department of Emergency Medicine, University of California Davis School of Medicine, Sacramento, California.
7
Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
8
Division of Pediatric Emergency Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
9
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota.
10
Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
11
Section of Emergency Medicine, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
12
Divisions of Infectious Diseases and.
13
Hospital Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Abstract

Although neonatal herpes simplex virus (HSV) causes significant morbidity, utilization of the cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) test remains variable. Our objective was to examine the association of CSF HSV PCR testing with length of stay (LOS) in a 20-center retrospective cohort of hospitalized infants aged ≤60 days undergoing evaluation for meningitis after adjustment for patient-level factors and clustering by center. Of 20,496 eligible infants, 7,399 (36.1%) had a CSF HSV PCR test performed, and 46 (0.6% of those tested) had a positive test. Infants who had a CSF HSV PCR test performed had a 23% longer hospital LOS (incident rate ratio 1.23; 95% CI: 1.14-1.33). Targeted CSF HSV PCR testing may mitigate the impact on LOS for low-risk infants.

PMID:
31112493
PMCID:
PMC6686736
[Available on 2020-08-01]
DOI:
10.12788/jhm.3202

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