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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

 

  • References

  • 1 Nakamura T, Cohen AL, Schwartz S. et al. The global landscape of pediatric bacterial meningitis data reported to the World Health Organization-coordinated Invasive Bacterial Vaccine-Preventable Disease Surveillance Network, 2014-2019. J Infect Dis 2021; 224 (12, Suppl 2): S161-S173
    CrossrefPubMedGoogle Scholar
  • 2 Agrawal S, Nadel S. Acute bacterial meningitis in infants and children: epidemiology and management. Paediatr Drugs 2011; 13 (06) 385-400
    CrossrefPubMedGoogle Scholar
  • 3 Ahmed SS, Lessa FC, Coradin H. et al. High prevalence of vaccine-type infections among children with pneumococcal pneumonia and effusion after 13-valent pneumococcal conjugate vaccine introduction in the Dominican Republic. J Infect Dis 2021; 224 (12, Suppl 2): S228-S236
    CrossrefPubMedGoogle Scholar
  • 4 Kobayashi M, Abdul-Karim A, Milucky JL. et al. Estimating the economic burden of pneumococcal meningitis and pneumonia in northern Ghana in the African meningitis belt post-PCV13 introduction. Vaccine 2021; 39 (33) 4685-4699
    CrossrefPubMedGoogle Scholar
  • 5 Koelman DLH, van Kassel MN, Bijlsma MW, Brouwer MC, van de Beek D, van der Ende A. Changing epidemiology of bacterial meningitis since introduction of conjugate vaccines: 3 decades of national meningitis surveillance in the Netherlands. Clin Infect Dis 2021; 73 (05) e1099-e1107
    CrossrefPubMedGoogle Scholar
  • 6 Bystritsky RJ, Chow FC. Infectious meningitis and encephalitis. Neurol Clin 2022; 40 (01) 77-91
    Google Scholar
  • 7 Liesman RM, Strasburg AP, Heitman AK, Theel ES, Patel R, Binnicker MJ. Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis. J Clin Microbiol 2018; 56 (04) e01927-e01917
    CrossrefPubMedGoogle Scholar
  • 8 Barros Domingues R, Mendes-Correa MC, Vilela de Moura Leite FB, Vega Dos Santos M, Senne Soares CA. Evaluation of the utilization of FilmArray Meningitis/Encephalitis in children with suspected central nervous system infection: a retrospective case series. Pediatr Emerg Care 2022; 38 (02) 58-61
    CrossrefPubMedGoogle Scholar
  • 9 Cailleaux M, Pilmis B, Mizrahi A. et al. Impact of a multiplex PCR assay (FilmArray®) on the management of patients with suspected central nervous system infections. Eur J Clin Microbiol Infect Dis 2020; 39 (02) 293-297
    CrossrefPubMedGoogle Scholar
  • 10 Panuganti SK, Nadel S. Acute bacterial meningitis beyond the neonatal period. In: Long SS, Prober CG, Fischer M. eds. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018: 1428-1473
    Google Scholar
  • 11 Pfefferle S, Christner M, Aepfelbacher M, Lütgehetmann M, Rohde H. Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis. BMC Infect Dis 2020; 20 (01) 170
    CrossrefPubMedGoogle Scholar
  • 12 Bridge S, Hullsiek KH, Nerima C. et al. Evaluation of the BioFire® FilmArray® Meningitis/Encephalitis panel in an adult and pediatric Ugandan population. J Mycol Med 2021; 31 (03) 101170
    CrossrefPubMedGoogle Scholar
  • 13 Moffa MA, Bremmer DN, Carr D. et al. Impact of a multiplex polymerase chain reaction assay on the clinical management of adults undergoing a lumbar puncture for suspected community-onset central nervous system infections. Antibiotics (Basel) 2020; 9 (06) 282
    CrossrefPubMedGoogle Scholar
  • 14 Tansarli GS, Chapin KC. Diagnostic test accuracy of the BioFire® FilmArray® meningitis/encephalitis panel: a systematic review and meta-analysis. Clin Microbiol Infect 2020; 26 (03) 281-290
    CrossrefPubMedGoogle Scholar
  • 15 Byington CL, Kendrick J, Sheng X. Normative cerebrospinal fluid profiles in febrile infants. J Pediatr 2011; 158 (01) 130-134
    CrossrefPubMedGoogle Scholar
  • 16 Venkatesan A, Tunkel AR, Bloch KC. et al; International Encephalitis Consortium. Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis 2013; 57 (08) 1114-1128
    CrossrefPubMedGoogle Scholar
  • 17 Precit MR, Yee R, Pandey U. et al. Cerebrospinal fluid findings are poor predictors of appropriate FilmArray Meningitis/Encephalitis panel utilization in pediatric patients. J Clin Microbiol 2020; 58 (03) e01592-e19
    CrossrefPubMedGoogle Scholar
  • 18 Kim KS. Bacterial meningitis beyond the neonatal period. In: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ. eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Philadelphia: Elsevier; 2019: 309-336
    Google Scholar
  • 19 Messacar K, Gaensbauer JT, Birkholz M. et al. Impact of FilmArray meningitis encephalitis panel on HSV testing and empiric acyclovir use in children beyond the neonatal period. Diagn Microbiol Infect Dis 2020; 97 (04) 115085
    CrossrefPubMedGoogle Scholar
  • 20 Boudet A, Pantel A, Carles MJ. et al. A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital. PLoS One 2019; 14 (10) e0223887
    CrossrefPubMedGoogle Scholar