Evaluation of the selection of cerebrospinal fluid testing in suspected meningitis and encephalitis
Copyright © 2021 Elsevier Inc. All rights reserved..
Diagnostic stewardship interventions can decrease unnecessary antimicrobial therapy and microbiology laboratory resources and costs. This retrospective cross-sectional study evaluated factors associated with inappropriate initial cerebrospinal fluid (CSF) testing in patients with suspected community-acquired meningitis or encephalitis. In 250 patients, 202 (80.8%) and 48 (19.2%) were suspected meningitis and encephalitis, respectively. 207 (82.8%) patients had inappropriate and 43 (17.2%) appropriate testing. Any inappropriate CSF test was greatest in the immunocompromised (IC) group (n = 54, 91.5%), followed by non-IC (n = 109, 80.1%) and HIV (n = 44, 80%). Ordering performed on the general ward was associated with inappropriate CSF test orders (adjOR 2.81, 95% CI [1.08-7.34]). Laboratory fee costs associated with excessive testing was close to $300,000 per year. A stepwise algorithm defining empiric and add on tests according to CSF parameters and patient characteristics could improve CSF test ordering in patients with suspected meningitis or encephalitis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:102 |
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| Enthalten in: |
Diagnostic microbiology and infectious disease - 102(2022), 1 vom: 20. Jan., Seite 115571 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Morrison, Austin R [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Infective Agents |
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| Anmerkungen: |
Date Completed 20.01.2022 Date Revised 20.01.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.diagmicrobio.2021.115571 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a Diagnostic stewardship interventions can decrease unnecessary antimicrobial therapy and microbiology laboratory resources and costs. This retrospective cross-sectional study evaluated factors associated with inappropriate initial cerebrospinal fluid (CSF) testing in patients with suspected community-acquired meningitis or encephalitis. In 250 patients, 202 (80.8%) and 48 (19.2%) were suspected meningitis and encephalitis, respectively. 207 (82.8%) patients had inappropriate and 43 (17.2%) appropriate testing. Any inappropriate CSF test was greatest in the immunocompromised (IC) group (n = 54, 91.5%), followed by non-IC (n = 109, 80.1%) and HIV (n = 44, 80%). Ordering performed on the general ward was associated with inappropriate CSF test orders (adjOR 2.81, 95% CI [1.08-7.34]). Laboratory fee costs associated with excessive testing was close to $300,000 per year. A stepwise algorithm defining empiric and add on tests according to CSF parameters and patient characteristics could improve CSF test ordering in patients with suspected meningitis or encephalitis | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Cerebrospinal fluid (CSF) testing | |
| 650 | 4 | |a Diagnostic stewardship | |
| 650 | 4 | |a Encephalitis | |
| 650 | 4 | |a Meningitis | |
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| 700 | 1 | |a Jones, Mathew C |e verfasserin |4 aut | |
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| 700 | 1 | |a Samuel, Linoj P |e verfasserin |4 aut | |
| 700 | 1 | |a Ramadan, Ahmad R |e verfasserin |4 aut | |
| 700 | 1 | |a Alangaden, George J |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Susan L |e verfasserin |4 aut | |
| 700 | 1 | |a Kenney, Rachel M |e verfasserin |4 aut | |
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