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Evaluation of Discordant Results Between FilmArray Meningitis/Encephalitis Panel and Conventional Testing in

Maheswari Ekambaram1, Aleisha Nabower2, Prabi Rajbhandari3

  • 1Department of Pediatrics, Baylor Scott and White Medical Center, Round Rock, Texas, USA.

Journal of the Pediatric Infectious Diseases Society
|January 12, 2022
PubMed
Abstract

Insights

Discordant results between the FilmArray Meningitis/Encephalitis panel (MEP) and conventional testing are common in children. Clinical context is crucial when interpreting positive MEP results for central nervous system infections.

Area of Science:

  • Clinical microbiology
  • Infectious disease diagnostics
  • Pediatric neurology

Background:

  • The FilmArray Meningitis/Encephalitis panel (MEP) is a rapid diagnostic tool for central nervous system infections.
  • MEP exhibits known false-positive and false-negative rates compared to conventional testing methods.
  • Understanding discrepancies is vital for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate clinical characteristics, treatment decisions, and outcomes in pediatric patients with discordant results between MEP and conventional testing.
  • To analyze the frequency and nature of discrepancies in meningitis/encephalitis diagnostics.

Main Methods:

  • Multisite review of pediatric patients (≤18 years) with suspected CNS infection.
  • Comparison of MEP results with conventional methods including cerebrospinal fluid (CSF) culture, HSV PCR, and EV PCR.
  • Descriptive analysis of discordant cases and statistical comparison between groups.

Main Results:

  • Over half of bacterial pathogens detected by MEP showed discordant results (58%).
  • Significant differences in CSF parameters (pleocytosis, protein, glucose) were observed between concordant and discordant MEP/culture positive groups.
  • Discordances were noted for HSV and Enterovirus PCR results as well.

Conclusions:

  • Discordant results between MEP and conventional testing are frequent in pediatric CNS infection diagnostics.
  • Clinical correlation and context are essential when interpreting MEP results to guide treatment decisions.
Keywords:
central nervous systemcerebrospinal fluidenterovirusherpes simplex viruspediatric meningitis

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