Utility of the meningoencephalitis panel in management of neonates with temperature instability

For infants aged ≤ 60-days evaluated for temperature instability, we sought to ascertain if use of a multiplex meningoencephalitis panel (MEP) decreased length of hospital stay (LOS), antimicrobial length of therapy (LoT), and use of other molecular testing.

This was a retrospective cohort study of infants aged ≤ 60-days hospitalized for temperature instability between 1/2012 and 1/2022. Patients were included if blood and cerebrospinal fluid (CSF) cultures were negative for bacterial infection. Patients were categorized into groups by MEP availability and use. LOS, LoT, and use of other molecular tests were compared by MEP usage group.

A total of 2076 patients met study criteria; there was no difference between groups regarding sex, race, ethnicity, or age at admission. During the period of MEP availability (2017–2022), the test was performed for 156/1101 (14%) patients. Compared to eligible patients without the MEP performed, MEP use was associated with longer LOS (57.7 vs. 47.3 h, p < 0.0001) and longer LoT (37.4 vs. 35.5 h, p < 0.0001). Use of the MEP was also associated with performance of additional molecular tests. Patients with CSF obtained after antimicrobial initiation had longer LOS compared to those with CSF obtained before antimicrobials were initiated, and MEP use did not mitigate that.

Young infants without bacterial infection by blood or CSF culture that had the MEP performed had longer length of hospital stays, longer duration of antimicrobial therapy, and more molecular testing performed compared to those without the MEP performed. Further research focusing on clinical scenarios where MEP use may be most beneficial for infants with temperature instability is needed.

Not applicable.