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In Vivo Imaging Systems IVIS Detection of a Neuro-Invasive Encephalitic Virus
Published on: December 2, 2012
[Experience with the Biofire FilmArray® for infectious meningitis/encephalitis in a high complexity institution in
C A Romero-Hernández1,2, J L Zuleta-Motta1,2, N M Zapa-Pérez1,2
1Fundación Cardioinfantil, Bogotá DC, Colombia.
Introduction:
Infectious meningoencephalitis (IME) is a neurological emergency with a significant rate of morbidity and mortality. The Biofire FilmArray® meningitis/encephalitis (FAME) panel for testing in cerebrospinal fluid (CSF) has proven to be a valuable tool for the aetiological diagnosis of IME, facilitating targeted antimicrobial therapy. The aim is to determine the impact of the FAME panel on antimicrobial therapeutic decisions in patients with suspected IME in the first 24 hours of clinical assessment.
Patients And Methods:
This is a descriptive observational study that comments on the clinical manifestations, the neuroimaging and paraclinical findings, and the antibiotic therapy of patients with suspected IME. An analysis was performed to determine the impact of FAME on antimicrobial therapy in the first 24 hours of the clinical assessment of patients.
Results:
Altogether 44 patients were included. The average time required to obtain the result of the FAME panel for testing in CSF was nine hours, with 20.4% (9/44) of tests yielding positive results. Within 24 hours of clinical assessment, their outcome had an impact on antimicrobial treatment decisions in 75% (33/44) of cases. In patients with a high clinical suspicion of IME, the result of FAME made it possible to change the initial empirical therapy to a targeted therapy in 15% (3/20) of cases and to discontinue the initial empirical therapy in 35% (7/20) of the subjects. In patients with low clinical suspicion of IME, their result allowed 25% (6/24) to have their suspicion confirmed and they were started on targeted antibiotic therapy; in contrast, 70.8% (17/24) had their diagnosis ruled out and were not started on treatment.
Conclusions:
The result of the FAME panel for testing in CSF has a high impact on antimicrobial therapeutic decisions within 24 hours of clinical assessment. However, it must be interpreted with the clinical context, local epidemiology and other diagnostic studies.
Insights
The Biofire FilmArray® meningitis/encephalitis (FAME) panel significantly impacts antimicrobial therapy decisions for infectious meningoencephalitis (IME) within 24 hours. This diagnostic tool aids in tailoring treatment, improving patient outcomes in neurological emergencies.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Infectious meningoencephalitis (IME) presents a significant neurological emergency with high morbidity and mortality rates.
- Early and accurate etiological diagnosis is crucial for effective antimicrobial therapy in IME.
- The Biofire FilmArray® meningitis/encephalitis (FAME) panel offers a rapid diagnostic approach for IME.
Purpose of the Study:
- To evaluate the impact of the FAME panel on antimicrobial therapeutic decisions.
- To assess the influence of FAME results within the first 24 hours of clinical assessment for suspected IME.
Main Methods:
- A descriptive observational study was conducted.
- Data collected included clinical manifestations, neuroimaging, paraclinical findings, and antibiotic therapy.
- Analysis focused on the impact of FAME results on antimicrobial therapy within 24 hours.
Main Results:
- The FAME panel yielded positive results in 20.4% of 44 patients.
- FAME results influenced antimicrobial treatment decisions in 75% of cases within 24 hours.
- In high-suspicion cases, FAME guided therapy changes in 15% and discontinuation in 35%; in low-suspicion cases, it confirmed diagnosis in 25% and ruled it out in 70.8%.
Conclusions:
- The FAME panel significantly impacts antimicrobial therapeutic decisions for IME within 24 hours.
- Interpretation of FAME results requires consideration of clinical context, local epidemiology, and other diagnostic studies.
- FAME facilitates targeted antimicrobial therapy, potentially improving management of neurological emergencies.
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