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Impact of polymerase chain reaction results on patient management during a viral meningitis outbreak in Tropical North Queensland

Authors


  • Vicki Stonehouse, MBBS, Senior Medical Officer; Jeremy Furyk, MBBS MPH&TM FACEM FACTM, Staff Specialist, Adjunct Senior Lecturer; Robert Norton, FRCPA MD Director of Pathology.

Dr Jeremy Furyk, c/o The Townsville Hospital, 100 Angus Smith Drive, Douglas, Qld 4814, Australia. Email: jeremy_furyk@health.qld.gov.au

Abstract

Objectives: Enterovirus is the most commonly isolated pathogen in viral meningitis. We report on the first outbreak of viral meningitis in Tropical Queensland and the effect of polymerase chain reaction (PCR) results on antibiotic use and hospital length of stay.

Methods: Retrospective case series of consecutive patients presenting to the Townsville ED with viral meningitis were evaluated by examining hospital medical records. The study period was November 2008 to February 2009.

Results: Forty-three patients were available for full analysis of which 17 (40%) were female and 17 (40%) had a positive enteroviral PCR. Antibiotics were commenced on 37 (86%) of patients. There was no difference in hospital length of stay in patients with a negative versus positive PCR (2.52 vs 2.72 days, P = 0.68) or duration of antibiotic therapy (2.20 vs 1.94 days, P = 0.61).

Conclusion: In our study a positive result on PCR was not associated with a shorter hospital length of stay or a shorter duration of antibiotic therapy. This contrasts with previous reports on this topic and requires further evaluation.

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