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J Pediatr Infect Dis 2022; 17(05): 252-257
DOI: 10.1055/s-0042-1756711
Original Article

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

Alkan Bal 
1   Department of Pediatric Emergency, Medical School of Manisa Celal Bayar University, Manisa, Turkey
,
Eylem Ulas Saz
2   Division of Emergency Medicine, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
,
Sema Yildirim Arslan
3   Division of Infectious Disease, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
,
Sinem Atik
4   Department of Pediatrics, Medical School of Manisa Celal Bayar University, Manisa, Turkey
,
Semra Bayturan
5   Division of Infectious Disease, Department of Pediatrics, Medical School of Manisa Celal Bayar University, Manisa, Turkey
,
Ali Yurtseven
2   Division of Emergency Medicine, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
,
Hörü Gazi
6   Department of Microbiology, Medical School of Manisa Celal Bayar University, Manisa, Turkey
,
Candan Cicek
7   Department of Microbiology, Medical School of Ege University, Izmir, Turkey
,
Zafer Kurugol
3   Division of Infectious Disease, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
,
Zumrut Sahbudak Bal
3   Division of Infectious Disease, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
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Abstract

Objective Acute bacterial meningitis (ABM) declined after implementing conjugate Haemophilus influenzae type B and the pneumococcal vaccines worldwide. However, it still contributes to significant morbidity and mortality. The Biofire FilmArray Meningitis Encephalitis (FAME) panel can rapidly diagnose common bacterial and viral pathogens. Several studies suggested that the use of FAME may accelerate diagnosis and decrease the time to pathogen-specific therapy. However, the clinical utility is still controversial due to scarce data and relatively high costs. Therefore, we aimed to evaluate the diagnostic performance of FAME in children.

Methods A retrospective multicenter cross-sectional study was conducted to evaluate FAME in diagnosing ABM in children with a suspected central nervous system infection between January 2017 and May 2021.

Results This study consisted of 179 children diagnosed with central nervous system infection who had parallel testing done using FAME and traditional microbiological diagnostic methods. Twenty-two FAME results were positive; 8 (36.3%) were bacterial pathogens and 14 (53.7%) were viral pathogens. The most common viral pathogen was human herpesvirus 6 (n  = 6; 27.2%), followed by herpes simplex virus 1 (n = 4; 18.1%), Enterovirus spp. (n = 2; 9%), Parechovirus (n = 2; 9%), and Cytomegalovirus (n = 1; 4.5%). Bacterial pathogens included S. pneumoniae (n = 3; 13.6%), H. influenzae (n = 3; 13.6%), Neisseria meningitidis (n = 1; 4.5%), and Streptococcus agalactiae (n = 1; 4.5%). Bacterial culture confirmed S. pneumoniae infection in only 1 of 8 (12.5%) patients, while 7 of 8 bacterial meningitis were only detected by FAME.

Conclusion FAME may also help with diagnosis and pathogen identification in patients who have already had antibiotics before cerebrospinal fluid collection. The use of FAME to detect infections quickly may minimize the improper use of medications, treatment duration, and the cost of hospitalization.

Keywords

bacterial meningitis - encephalitis - FAME - multiplex PCR


Publication History

Received: 21 March 2022

Accepted: 07 July 2022

Article published online:
28 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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