A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital

Autoři: Agathe Boudet aff001;  Alix Pantel aff001;  Marie-Josée Carles aff002;  Hélène Boclé aff003;  Sylvie Charachon aff002;  Cécilia Enault aff002;  Robin Stéphan aff001;  Lucile Cadot aff004;  Jean-Philippe Lavigne aff001;  Hélène Marchandin aff005
Působiště autorů: U1047, INSERM, Montpellier University, Department of Microbiology, Nîmes University Hospital, Nîmes, France aff001;  Department of Microbiology, Nîmes University Hospital, Nîmes, France aff002;  U1047, INSERM, Montpellier University, Department of Infectious Diseases, Nîmes University Hospital, Nîmes, France aff003;  Laboratory of Medical Biology, Alès General Hospital, Alès, France aff004;  HydroSciences Montpellier, CNRS, IRD, Montpellier University, Department of Microbiology, Nimes University Hospital, Nîmes, France aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0223887


Early diagnosis and treatment of meningitis and encephalitis is essential for reducing both their morbidity and mortality. The FilmArray® Meningitis/Encephalitis (FA-M/E) panel is a recently available molecular tool allowing the simultaneous detection of 14 pathogens in about one hour. We evaluated its routine use over a 13-month period at Nîmes University Hospital, France. Cerebrospinal fluid (CSF) specimens were prospectively analyzed, independently of cell count; results were retrospectively analyzed and positive results compared to clinical and microbiological data. Among the 708 patients included (734 CSF samples), 89 (12.6%) had a positive FA-M/E panel, 71 (80%) for a viral pathogen and 18 (20%) for a bacterial pathogen. Enterovirus and HHV-6 were the main detected pathogens. Mean time-to-results was 1h46mn. Four non-clinically relevant results were detected (3 HHV-6 and 1 Haemophilus influenzae) on the basis of inconsistent clinical and/or biological data, and/or after visualization of melting curves. No CSF pleocytosis was observed in 11% of the patients with a positive FA-M/E panel. For the 18 patients with a positive FA-M/E panel for a bacterial pathogen, five (28%) had CSF samples showing a positive Gram stain allowing an early diagnosis of bacterial infection and 67% had CSF displaying a positive culture. Altogether the panel detected 5 cases of bacterial M/E (29%) not diagnosed by culture. Despite undeniable advantages, mainly ease of use, quick result availability, and an extremely low rate of invalid results, measures should be implemented to limit false-positive results due to contamination and a careful interpretation based on the overall data for each patient is required.

Klíčová slova:

Bacterial pathogens – Cerebrospinal fluid – Melting – Pediatric infections – Pediatrics – Physicians – Pneumococcus – Haemophilus influenzae


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