Impact of cerebrospinal fluid syndromic testing in the management of children with suspected central nervous system infection
Abstract
The aim of the study was to evaluate the impact of the use of BioFire® FilmArray® meningitis/encephalitis(FA-ME) panel which enables rapid automated CSF testing for 14 common viral, bacterial, and yeast pathogens that cause CNS infections, in the management of children with suspected CNS infection. A prospective cohort study was performed on children admitted to a tertiary pediatric hospital, over a period of 1 year, with possible CNS infection and CSF pleocytosis (> 15 cells/mm 3). Children were randomized 1:1, either to use FA-ME or separate molecular CSF microbiological tests according to usual pediatric practice in the hospital. Length of hospital stay, duration of antimicrobials, and total cost of hospitalization were compared between groups. A total of 142 children were included in the study (71 cases). A pathogen was detected in 37/71(52.1%) children with the use of FA-ME and in 16/71(22.5%) in the control group (P value < 0.001). In aseptic meningitis cases a virus was detected in 27/61(44.2%) and in 11/66(16.7%) controls (P value < 0.001). Median (IQR) length of stay in cases and controls with aseptic meningitis was 5(4-8) and 8(6-10) days, respectively (P value < 0. 001). The median (IQR) duration of antimicrobials in cases and controls was 4(2-5.7) and 7(5-10) days, respectively (P value < 0.001). The hospitalization cost was calculated in cases and controls 1042€ (932-1372) and 1522€ (1302-1742), respectively (P value < 0.001). The use of FA-ME was able to reduce significantly the use of antimicrobials, the hospitalization days, and the total cost comparing to the control group in children with suspected CNS infection.
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The BioFire® FilmArray® Meningitis/Encephalitis Panel (FA-ME) is capable of simultaneous detection of 14 pathogens in minimal CSF volumes, offering reduced turnaround time and high diagnostic accuracy.
“The BioFire® FilmArray® Meningitis/Encephalitis Panel (FA-ME) is the first commercially available multiplex PCR assay, capable of simultaneous detection of 14 pathogens (Fig. 1) in minimal CSF volumes, offering reduced turnaround time and high diagnostic accuracy [1, 3, 17–19].”
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- Authors
- Posnakoglou, L., Siahanidou, T., Syriopoulou, V., & Michos, A.
- Affiliations
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Michos, Athanasios
- Venue
- European Journal of Clinical Microbiology & Infectious Diseases
- Published
- 2020-07-18
- Volume
- 39
- Issue
- 12
- Pages
- 2379-2386
- ISSN
- 0934-9723 (ISSN-L)
- 1435-4373
- OpenAlex
- W3042865414
- Cited by
- 42
- References
- 40
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 6 · 2022: 13 · 2021: 8 · 2020: 1
- FWCI
- 5.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Keywords
- central nervous system infection, pediatric meningitis, aseptic meningitis, encephalitis, cerebrospinal fluid pleocytosis, molecular diagnosis, antimicrobial duration, length of hospital stay, hospital costs, pathogen detection
- MeSH terms
- Adolescent, Bacteria, Central Nervous System Infections, Cerebrospinal Fluid, Child, Child, Preschool, Diagnostic Tests, Routine, Encephalitis, Female, Greece, Hospitalization, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Male, Meningitis, Prospective Studies, Viruses, Multiplex Polymerase Chain Reaction
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