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This retrospective single-center study evaluated the utility of positive cerebrospinal fluid (CSF) multiplex polymerase chain reaction (PCR) results using FilmArray Meningitis/Encephalitis Panel in children admitted from June 1, 2016 to August 31, 2018. Among 79 children, 73% had viral and 27% bacterial meningitis; viruses were identified across age groups. Antibiotics were stopped within 24 hours for many viral cases, and organisms were detected even with inadequate CSF samples or negative cultures after pretreatment. Reported hospital stay and antibiotic duration were substantially shorter for viral meningitis. Results support the panel’s rapid, specific, and sensitive diagnostic value, with recommendations for pediatric use.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/csf-multiplex-pcr-meningitis-panel-in-children-clinical-utility-and-impact-on-antimicrobial-management/454503/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/csf-multiplex-pcr-meningitis-panel-in-children-clinical-utility-and-impact-on-antimicrobial-management/454503.png","ImageObject",300,407,{"name":92,"@type":93},"Angel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s primary aim?","Question",{"text":112,"@type":113},"To evaluate the utility of positive CSF PCR results and how they help manage pediatric meningitis.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were antibiotic pretreatment and respiratory distress defined?",{"text":117,"@type":113},"Antibiotic pretreatment was antibiotics received within seven days before lumbar puncture. Respiratory distress was defined using age-based tachypnea, retractions, or grunting per the Pediatric Advanced Life Support manual.",{"name":119,"@type":110,"acceptedAnswer":120},"Did the CSF multiplex panel change antibiotic therapy decisions?",{"text":121,"@type":113},"The study reports that modification of antibiotic therapy was never the result of the CSF multiplex panel.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},454503,1791088146,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},687207412472,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","University of South Alabama  \nUniversity of South Alabama  \nUniversity of Texas Health Science Center  \nUniversity of South Alabama  \nUniversity of South Alabama  \nPediatrics, lumbar puncture, pretreatment, viral meningitis  December 17th, 2025  \n [https://doi.org/10.21203/rs.3.rs-7871089/v1](https://doi.org/10.21203/rs.3.rs-7871089/v1)  \n 􀁱 􀅏 This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License  No competing interests reported.  \nMeningitis has signi«cant clinical morbidity and mortality in children. Mortality in children, especially neonates, is high due to diagnostic di culty. Diagnosis of pediatric meningitis is traditionally made using CSF parameters and cultures. The performance of cerebrospinal ¬uid (CSF) multiplex polymerase chain reaction (PCR) meningitis panel needs further evaluation in the pediatric population.  \nMedical records of children with a positive CSF multiplex panel (June 1, 2016 to August 31, 2018) were reviewed retrospectively. We extracted data about antimicrobials used, laboratory and culture results, duration of antibiotic treatment and hospital stay.  \nA total of 79 children (age, 1 d to 12 y) were identi«ed, including 58 children with viral (73%) and 21 children (27%) with bacterial meningitis. The most frequent viruses were enterovirus in all age groups. Empiric antibiotics were discontinued within 24 h in 14 of 40 patients (35%) positive for viral meningitis. Speci«c antiviral therapy was rapidly initiated in 6 out of 58 patients (10%) . Antibiotics were stopped or never initiated when viral etiology was identi«ed. Even when the CSF sample was inadequate for analysis, the pathogenic organism was identi«ed particularly helpful in the infants. In antibiotic pretreated patients, the organism was identi«ed even when the cultures were negative. CSF multiplex panel identi«ed 13 patients who had bacterial meningitis despite negative CSF cultures. Twelve of these 13 patients (92%) were pretreated with antibiotics. Modi«cation of antibiotic therapy was never the result of CSF multiplex panel. Duration of antibiotic treatment and hospital stay were substantially shorter in patients with viral as opposed to bacterial meningitis.  \nCSF multiplex panel saves brain as it is rapid, speci«c, and highly sensitive. It also reduces the healthcare cost, and its use is highly recommended in a pediatric population.  \nIn children with or without disseminated illness, meningitis has signi«cant clinical morbidity and mortality [1] . Mortality is multifactorial and can vary with the causative pathogen. Despite the availability of effective antibiotics to treat bacterial meningitis, 50% of children may experience neurologic sequelae, and mortality is high (5% to 30%), especially in neonates, in part because of diagnostic di culty [2, 3] .  \nIn Pediatrics, the incidence of meningitis is highest under 6 months of age [4] . Clinical examination is not su cient for diagnosis as symptoms and signs of meningitis in children are variable and nonspeci«c [5] . In neonates, clinical presentation varies even more. The most common symptoms prompting diagnostic lumbar puncture in the emergency room include fever, seizures, and/or unexplained altered mental status [3] . Laboratory con«rmation of bacterial meningitis is ascertained by cerebrospinal ¬uid (CSF) Gram stain and culture. Treatment with empiric antibiotics before obtaining CSF studies can affect the sensitivity of culture and Gram stain [6] . The sensitivity of CSF Gram stain is 60% to 80% inpatients without antibiotic pretreatment and decreases by 20% with antibiotic pretreatment [7] . CSF bacterial culture is positive in 8% of patients who have meningitis [8] but is a useful diagnostic test even though results may not be available for two days, because it provides information about the pathogen and antimicrobial sensitivity [9] . Parameters such as CSF protein level, glucose level, and white blood cell (WBC) count maybe inco","cbCaihEl76wlH2qo","https://ap.wps.com/l/cbCaihEl76wlH2qo","pdf",1058176,11,"English","# Background\n## Diagnostic challenges and limitations of CSF culture\n# Study Design\n## Retrospective cohort and inclusion criteria\n## Data collection and definitions\n# Results\n## Patient characteristics and detected pathogens\n## Antibiotic discontinuation and antiviral initiation\n## Impact of CSF multiplex results on organism detection\n## Hospital stay and treatment duration\n# Discussion\n## Diagnostic utility, sensitivity, and clinical recommendations","[{\"question\":\"What was the study’s primary aim?\",\"answer\":\"To evaluate the utility of positive CSF PCR results and how they help manage pediatric meningitis.\"},{\"question\":\"How were antibiotic pretreatment and respiratory distress defined?\",\"answer\":\"Antibiotic pretreatment was antibiotics received within seven days before lumbar puncture. Respiratory distress was defined using age-based tachypnea, retractions, or grunting per the Pediatric Advanced Life Support manual.\"},{\"question\":\"Did the CSF multiplex panel change antibiotic therapy decisions?\",\"answer\":\"The study reports that modification of antibiotic therapy was never the result of the CSF multiplex panel.\"}]","CSF Multiplex PCR Meningitis Panel in Children - Clinical Utility and Impact on Antimicrobial Management | PDF",1790740813,28]