Article in Japanese

Usefulness of the in-house real-time PCR of cerebrospinal fluid from infants less than 90 days of age with suspicion of herpes simplex virus encephalitis

Daichi SUZUKI¹⁾, Kensuke SHOJI²⁾, Chitose KOYAMA (WAKAI)²⁾, Ippei MIYATA³⁾, Noriyasu IWASE⁴⁾, Isao MIYAIRI²⁾

Acyclovir (ACV), which is administered in cases of suspected neonatal herpes simplex virus (HSV) encephalitis, is usually terminated based on a negative cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR). PCR testing for HSV is generally performed at an outside hospital laboratory, requiring several days from test order until result reporting. At this facility, in-house real-time PCR testing for HSV was introduced in 2009. It examined usefulness of the in-house HSV-PCR of CSF obtained from infants less than 90 days old between March 2002 and August 2016. The subjects were classified into an out-of-hospital measurement group and an in-house measurement group, and the number of examinations performed, time required for results reporting, duration of treatment, and length of hospital stay (LOS) were compared between these groups. CSF HSV-PCR tests were performed in 118 cases, of which 19 (16%) and 99 (84%) were out-of-hospital and in-house assessments, respectively. The time required for results reporting, ACV administration period, and LOS were significantly shorter (p <0.05) (median 5.5 days vs 1.0 days, 6.0 days vs 2.0 days, 17.0 days vs 8.0 days). However, the number of examinations increased from 2.3 per year to 14.6 per year after in-house testing was initiated, suggesting that the threshold for conducting the examination might have decreased. While the introduction of in-house PCR testing proved to be useful, the appropriate criteria for performing the tests appears to be necessary.

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1) Department of Postgraduate Education and Training, National Center for Child Health and Development
2) Division of Infectious Diseases, Department of Medical Subspecialties, National Center for Child Health and Development
3) Department of Pediatrics, Kawasaki Medical School
4) Research Institute for Microbial Diseases, Osaka University

Key words	neonatal herpes simplex virus infection, real-time PCR, acyclovir
Received	September 21, 2017
Accepted	December 22, 2017

30 (1)：3─9,2018