Implementation of the BIOFIRE Meningitis/Encephalitis Panel: A Mixed-Methods Implementation Study in a
Shradha Subedi1,2, N A Patrick Harris1,3, Lisa Hall4
1University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
Open Forum Infectious Diseases
|May 11, 2026
Summary
Implementing a rapid meningitis and encephalitis (ME) panel improved diagnostic efficiency and clinician confidence in antimicrobial decision-making. Multidisciplinary collaboration and education were key to successful adoption of this syndromic testing approach.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Health Services Research
Background:
- Meningitis and encephalitis (ME) pose significant health risks, necessitating rapid pathogen identification for effective treatment and antimicrobial stewardship (AMS).
- The BIOFIRE® FILMARRAY® ME panel offers simultaneous detection of multiple pathogens from cerebrospinal fluid (CSF) samples.
- Evaluating the implementation strategy and clinician adoption of this panel is crucial for optimizing its use in clinical settings.
Purpose of the Study:
- To assess the implementation strategy of the BIOFIRE® FILMARRAY® ME panel in a large nonmetropolitan tertiary hospital.
- To evaluate clinician adoption and its impact on diagnostic efficiency and antimicrobial decision-making.
- To identify factors influencing the successful integration of the ME panel into clinical practice.
Main Methods:
- A mixed-methods study design was employed at Sunshine Coast University Hospital.
- Data collection involved clinician surveys and semistructured interviews assessing knowledge, confidence, and practices.
- Quantitative and qualitative data were analyzed using descriptive statistics and thematic analysis, respectively.
Main Results:
- Clinician confidence in discontinuing antibiotics based on assay results significantly increased post-implementation (18% to 52%).
- Perceived usefulness of rapid CSF PCR testing was high (median 9/10).
- Key themes influencing implementation included ordering practices, diagnostic value, result trust, AMS, and behavioral change, with infectious diseases input enhancing interpretation confidence.
Conclusions:
- The syndromic panel enhanced diagnostic efficiency and clinician confidence in antimicrobial prescribing.
- Sustained education, multidisciplinary collaboration, and integrated stewardship frameworks are vital for successful panel adoption.
- Effective implementation strategies are essential for optimizing the clinical utility of rapid diagnostic panels in managing ME.
