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Point-of-care multiplexed diagnosis of meningitis using the FilmArray® ME panel technology
Jean-Jacques Vincent1, Christine Zandotti1, Sophie Baron1,2
1Laboratoire de Microbiologie, IHU Méditerranée Infection, Marseille, France.
Abstract:
Infectious meningitis is a medical urgency and rapid detection of the causative pathogen into the cerebrospinal fluid (CSF) is mandatory to guide the management of patients. We compared the performances of the multiplexed PCR FilmArray® ME panel with standard microbiological analyses, for rapid diagnosis of infectious meningitis. All the CSF samples received in our routine laboratory for the diagnosis of infectious meningitis were prospectively analyzed by the FilmArray® ME panel for the detection of fourteen targets in parallel to standard routine real-time PCR assays and bacterial culture. We reviewed clinical and biological records of patients for whom a discrepant result was obtained to achieve a definite diagnosis. Among 1124 CSF samples tested over a 43-week period, 113 (10.1%) and 87 (7.74%) were positive using the FilmArray® ME panel and the standard techniques, respectively. Among 40 CSF samples which yielded discrepant results, 34 were positive only using the FilmArray® ME panel and 6 were positive only using standard techniques. A total of 16/34 (47.1%) FilmArray® ME panel-positive CSF, and 6/6 (100%) of standard technique-positive CSF were interpreted as true positive. We were able to estimate the sensitivity, the specificity, the positive predictive value, and the negative predictive value of the FilmArray® ME panel at 94.2%, 98.2%, 84.3%, and 99.4%, respectively. The FilmArray® ME panel is an efficient tool for the rapid diagnosis of infectious meningitis at the point-of-care. Its higher sensitivity compared with that of standard molecular biology and culture techniques yields an increase of true positive diagnosis.
Insights
The FilmArray® ME panel offers a faster and more sensitive method for diagnosing infectious meningitis by detecting pathogens in cerebrospinal fluid (CSF). This molecular diagnostic tool improves the accuracy of infectious meningitis diagnoses compared to standard laboratory methods.
Area of Science:
- Clinical Microbiology
- Molecular Diagnostics
- Infectious Diseases
Background:
- Infectious meningitis requires urgent diagnosis for effective patient management.
- Rapid pathogen identification in cerebrospinal fluid (CSF) is critical.
Purpose of the Study:
- To compare the performance of the FilmArray® ME panel against standard microbiological analyses for diagnosing infectious meningitis.
- To evaluate the FilmArray® ME panel's efficiency in rapid pathogen detection in CSF.
Main Methods:
- Prospective analysis of 1124 CSF samples using the FilmArray® ME panel and standard techniques (real-time PCR, bacterial culture).
- Review of clinical and biological records for discrepant results to establish a definitive diagnosis.
- Calculation of sensitivity, specificity, positive predictive value, and negative predictive value for the FilmArray® ME panel.
Main Results:
- The FilmArray® ME panel identified 113 positive cases (10.1%), while standard techniques identified 87 (7.74%).
- Of 40 discrepant results, 34 were positive only by FilmArray® ME, and 6 only by standard techniques.
- Estimated performance metrics for FilmArray® ME panel: 94.2% sensitivity, 98.2% specificity, 84.3% PPV, and 99.4% NPV.
Conclusions:
- The FilmArray® ME panel is an effective tool for the rapid, point-of-care diagnosis of infectious meningitis.
- Its higher sensitivity compared to standard methods increases the detection of true positive cases.
