Evaluation of the Utilization of FilmArray Meningitis/Encephalitis in Children With Suspected Central Nervous System Infection

Abstract

Background:The etiology of central nervous system infections is often difficult to establish. FilmArray meningitis/encephalitis (ME) panel is a multiplex polymerase chain reaction for rapid identification of 14 pathogens. The aim of this study was to evaluate potential real-life contributions of the use of this method in the pediatric population. Methods:We herein report the results obtained with FilmArray ME in a retrospective case series of 367 children with suspected central nervous system infection. We identified viral and bacterial agents by FilmArray, and we evaluated the potential diagnostic contributions of the use of the panel taking into account the cytological, biochemical, and microbiological results of the cerebrospinal fluid (CSF) analysis. Results:The FilmArray ME panel detected a viral infection in 186 cases (50.7%) and a bacterial infection in 12 cases (3.3%). Fifty-three cases (28.4%) of viral infection had at least 1 CSF finding that could be mistaken for bacterial meningitis. Enterovirus was identified in 2 cases with normal CSF findings. Among 12 bacterial infection cases, only 6 (50%) had a positive result with conventional microbiology analysis (Gram stain and culture). The CSF findings suggestive of bacterial meningitis were found in all 6 cases in which FilmArray was the only method to identify bacterial etiological agent.Conclusions: FilmArray ME panel identified an etiological agent in cases in which conventional CSF analysis failed, providing potential clinical contributions to the management of such cases.

The Evaluation of the Diagnostic Performance of the BioFire FilmArray Meningitis/Encephalitis Panel in Children: A Retrospective Multicenter Study

“…Similar to our results, Messacar et al 19 demonstrated reduced acyclovir treatment and treatment duration for HSV-positive patients by FAME compared with positive HSV results by single-plex PCR. Barros Domingues et al 8 evaluated 367 FAME that were positive with identification of virus (viral infection) in 186 (50.7%) and positive with identification of a bacterial agent (bacterial infection) in 12 (3.3%). The most common viral pathogen was Enterovirus spp.…”

“…Few studies evaluated FAME performance in the diagnosis and the effects on treatment duration, hospital stay, and hospital costs. 8 10 11 12 13 14 Therefore, we aimed to compare the performance of FAME, a molecular diagnostic method, in children with suspected ABM to traditional microbiological diagnostic methods such as cell counts and differentials, glucose and protein concentrations, microscopy, Gram staining, and bacterial culture from a CSF sample.…”

“…7 Another recent study determined a pathogen in 50.7% of 367 CSF samples, and 3.3% of the samples were positive for a bacterial pathogen. 8 Cailleaux et al 9 conducted a prospective study and demonstrated shorter empirical anti-infective treatment in 42 patients (32%) and a shorter hospital stay in 23 patients (18%), with a cost reduction of €26,242 (€201/ patient).…”