PCR evaluation of CSF for confirming meningitis is costly
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PCR evaluation of CSF for confirming meningitis is costly Polymerase chain reaction (PCR) evaluation of cerebrospinal fluid (CSF) appears to be a costly over-ordered method of confirming meningitis, according to findings of a US study presented as an abstract at ASM* Microbe Online 2020. The costs and outcomes of screening using PCR CFS analysis versus standard CSF analysis were compared in 320 adult patients with clinical symptoms of meningitis between July 2017 and July 2019 who were screened by both methods of CSF analysis. PCR systems were assumed to cost $200 000. PCR analysis results were positive in 47 patients, and were not correlated with high white blood cell (WBC) count. PCR tests were positive in 41% of patients with a meningitis profile (high WBC count, high protein level, low glucose level), and in 5% of patients with a normal profile (normal WBC, protein and glucose values). It was estimated that 6.5 PCR tests would need to be run for every positive test. "Within an initial cost of $200,000, a disposable cost of $150 per test and detection rate of 14.7%, initial costs to detect a single positive test by PCR could approach $4,500. We are currently reviewing clinical outcomes. PCR should be used judiciously following history, physical exam and standard CSF workup, rather than as a screening tool," concluded the authors. * American Society for Microbiology DeRosa PA, et al. Meningitis Multiplex-PCR: 3 Year Study of Cost and Correlation with Traditional CSF Analysis. ASM Microbe Online 2020 : abstr. N/A, 22 Jun 2020.
1173-5503/20/0861-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
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PharmacoEconomics & Outcomes News 5 Sep 2020 No. 861
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