Cerebrospinal Fluid Enterovirus Testing in Infants 56 Days or Younger

Study of neonates and young infants at Children’s Hospital of Philadelphia indicates that cerebrospinal fluid (CSF) enterovirus polymerase chain reaction (PCR) testing of febrile neonates decreases hospital length of stay (LOS) for febrile infants 56 days old or younger.

Lumbar puncture is a routine part of evaluating febrile infants and patients often remain hospitalized waiting for results. CSF enterovirus PCR testing can rapidly and accurately diagnose infections, and therefore reduce patients’ LOS.

This was a retrospective cohort study, conducted on 1,256 febrile infants up to 56 days old. The authors analyzed medical records data on the infants, examining variables such as age, bacterial infection and the enterovirus season. They also examined associations between CSF enterovirus PCR testing and LOS.

Positive CSF enterovirus PCR results were found to decrease LOS, while infants who tested negative had a similar LOS to untested infants. There was no significant difference in test turnaround time for positive versus negative test results, so availability of the test results is likely not a factor in LOS differences.

This study only included data from one hospital, however, and lacked sufficient data from outside the enterovirus season. The usefulness of testing also depends on rapid laboratory turnaround time, which is not available everywhere. Further study is therefore needed to assess the applicability of these results to other populations and places.