Multiplex real-time PCR FilmArray performance in the diagnosis of meningoencephalitis: lights and shadows
Open accessAbstract
PURPOSE: We aimed to evaluate the performance of the FilmArray (FA) meningitis/encephalitis (ME) panel. Secondarily, we analyzed the false positive (FP) and false negative (FN) results, as well as the predictive values of the technique, regarding the cerebrospinal fluid (CSF) characteristics. METHODS: FA is a multiplex real-time PCR detecting 14 of the most common ME pathogens in CSF. All FA performed at our hospital (2018-2022) were retrospectively reviewed. FA was compared to conventional techniques and its performance was assessed based on the final diagnosis of the episode. RESULTS: FA was performed in 313 patients with suspicion of ME. Most patients had altered mental status (65.2%) and fever (61%). Regarding CSF characteristics, 49.8% and 53.7% presented high CSF proteins and pleocytosis, respectively. There were 84 (26.8%) positive FA results, mainly for HSV-1 (10.9%), VZV (5.1%), Enterovirus (2.6%), and S. pneumoniae (1.9%). In the 136 cases where both FA and routine methods were performed, there was a 25.7% lack of agreement. We identified 6.6% FN results, but 28.6% FP, mainly due to HSV-1. This resulted in a high negative predictive value (NPV) of 93.4%, but a positive predictive value (PPV) of 73%. Remarkably, PPV as low as 36.9%, and 70.2%, were found in cases without pleocytosis, or lack of high CSF protein levels, respectively. CONCLUSION: FA was associated with high NPV, but frequent FP results and low PPV, particularly for HSV-1, and especially in patients without high CSF protein levels or pleocytosis.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Published positivity rates for CSF multiplex PCR range from 18.8% to 32.8%.
“Published positivity rates for CSF multiplex PCR range from 18.8% to 32.8%10, 11, 12, aligning with our positivity rate of 24.3%.”
From Clinical Impact of Cerebrospinal Fluid Multiplex Polymerase Chain Reaction (PCR) Testing in Children with Suspected Central Nervous System Infection (2025) · cites this paper as [10]
The Results (Table 3; page unavailable) report a 26.8% positive FilmArray rate, which falls within the claimed range. But the Discussion (page unavailable) describes prior studies’ positivity rates as 8–25%, not 18.8–32.8%; this source does not support the stated endpoints. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Epidemiology, Diagnosis, and Antimicrobial Treatment of Acute Bacterial Meningitis
Brouwer, M. C., Tunkel, A. R., & van de Beek, D. (2010) · Clinical Microbiology Reviews · doi:10.1128/cmr.00070-09 · Cited by 930 · cited 1× · see citing works
“However, conventional microbiological techniques to diagnose ME remain slow and frequently low-yielded [4].”
BackgroundEdmond, K., Clark, A., Korczak, V. S., Sanderson, C., Griffiths, U. K., & Rudan, I. (2010) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(10)70048-7 · Cited by 631 · see citing works
Leber, A. L., Everhart, K., Balada-Llasat, J.-M., Cullison, J., Daly, J., Holt, S., Lephart, P., Salimnia, H., Schreckenberger, P. C., DesJarlais, S., et al. (2016) · Journal of Clinical Microbiology · doi:10.1128/jcm.00730-16 · Cited by 609 · cited 2× · see citing works
“One potential hypothesis would be that positive HSV-1 from the blood instead of CSF is being detected due to hematic contamination of the sample [8, 11].”
BackgroundResultTansarli, G. S., & Chapin, K. C. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2019.11.016 · Cited by 263 · cited 5× · see citing works
“Like previous reports [7, 8], high specificity and NPV (89.9% and 93.4%, respectively) were obtained.”
BackgroundResultInfluentialLiesman, R. M., Strasburg, A. P., Heitman, A. K., Theel, E. S., Patel, R., & Binnicker, M. J. (2018) · Journal of Clinical Microbiology · doi:10.1128/jcm.01927-17 · Cited by 186 · see citing works
Trujillo-Gómez, J., Tsokani, S., Arango-Ferreira, C., Atehortúa-Muñoz, S., Jimenez-Villegas, M. J., Serrano-Tabares, C., Veroniki, A.-A., & Florez, I. D. (2022) · EClinicalMedicine · doi:10.1016/j.eclinm.2022.101275 · Cited by 139 · see citing works
Radmard, S., Reid, S., Ciryam, P., Boubour, A., Ho, N., Zucker, J., Sayre, D., Greendyke, W. G., Miko, B. A., Pereira, M. R., et al. (2019) · Frontiers in Neurology · doi:10.3389/fneur.2019.00281 · Cited by 116 · cited 1× · see citing works
“These findings contrast with previous studies where overall agreement between techniques was found in over 80–90% of cases [11, 13–15].”
ResultDiagnosis and Treatment of Central Nervous System Infections in the Emergency Department
Dorsett, M., & Liang, S. Y. (2016) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2016.06.013 · Cited by 109 · see citing works
Hanson, K. E., Slechta, E. S., Killpack, J. A., Heyrend, C., Lunt, T., Daly, J. A., Hemmert, A. C., & Blaschke, A. J. (2016) · Journal of Clinical Microbiology · doi:10.1128/jcm.02850-15 · Cited by 86 · see citing works
Dynamics of pcr-based diagnosis in patients with invasive meningococcal disease
Bronska, E., Kalmusova, J., Dzupova, O., Maresova, V., Kriz, P., & Benes, J. (2006) · Clinical Microbiology and Infection · doi:10.1111/j.1469-0691.2005.01327.x · Cited by 61 · see citing works
Assessment of the FilmArray ME Panel in 4199 Consecutively Tested Cerebrospinal Fluid Samples
Lindström, J., Elfving, K., Lindh, M., Westin, J., & Studahl, M. (2022) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2021.05.017 · Cited by 48 · see citing works
Cailleaux, M., Pilmis, B., Mizrahi, A., Lourtet-Hascoet, J., Nguyen Van, J.-C., Alix, L., Couzigou, C., Vidal, B., Tattevin, P., & Le Monnier, A. (2020) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-019-03724-7 · Cited by 36 · see citing works
DiDiodato, G., & Bradbury, N. (2019) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofz119 · Cited by 32 · see citing works
Moffa, M. A., Bremmer, D. N., Carr, D. R., Buchanan, C., Shively, N. R., Elrufay, R., & Walsh, T. (2020) · Antibiotics · doi:10.3390/antibiotics9060282 · Cited by 26 · see citing works
Markovich, K., Wingler, M. J. B., Stover, K. R., Barber, K. E., Wagner, J. L., & Cretella, D. A. (2022) · Diseases · doi:10.3390/diseases10040110 · Cited by 22 · cited 1× · see citing works
“In such a context, FA could still be useful due to its high NPV [18, 19], but confirmation of positive results (with routine methods, radiology, etc.) is imperative.”
BackgroundPoint-of-care multiplexed diagnosis of meningitis using the FilmArray® ME panel technology
Vincent, J.-J., Zandotti, C., Baron, S. A., Kandil, C., Levy, P., Drancourt, M., Raoult, D., & Ninove, L. (2020) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-020-03859-y · Cited by 22 · see citing works
Seth, R. (2017) · JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH · doi:10.7860/jcdr/2017/28114.10532 · Cited by 18 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Molecular point-of-care testing technologies: Current status and challenges
Zu, Y., Chang, H., & Cui, Z. (2025) · Nexus · doi:10.1016/j.ynexs.2025.100059 · Cited by 53 · see citing works
Distinguishing community-acquired bacterial and viral meningitis: Microbes and biomarkers
Ivaska, L., Herberg, J., & Sadarangani, M. (2024) · Journal of Infection · doi:10.1016/j.jinf.2024.01.010 · Cited by 28 · see citing works
Poussier, L., Mailles, A., Tattevin, P., Stahl, J. ‐., Fillâtre, P., Abgrall, S., Argaud, L., Argemi, X., Asseray, N., Baille, G., et al. (2024) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2024.03.017 · Cited by 22 · see citing works
Adami, M., Giamarellos‐Bourboulis, E. J., & Polyzogopoulou, E. (2024) · Expert Review of Molecular Diagnostics · doi:10.1080/14737159.2024.2392283 · Cited by 10 · see citing works
Meningococcal meningitis in Spain in the Horizon 2030: A position paper
Llop, F. A. M., Andradas, E., Baviera, L. C. B., Cantón, R., del Castillo, J. M. G., Martinón‐Torres, F., Moya, E., Trilla, A., Vázquez, J. A., Villena, R., et al. (2024) · Revista Española de Quimioterapia · doi:10.37201/req/023.2024 · Cited by 5 · see citing works
GOKTUG, A., AK GUNDOGDU, I., DUYU, M., & BESLI, E. (2025) · Medeniyet Medical Journal · doi:10.4274/mmj.galenos.2025.43895 · Cited by 4 · see citing works
Paranhos‐Baccalà, G., Curião, T., Textoris, J., & Allantaz, F. (2024) · Diagnostics · doi:10.3390/diagnostics14171884 · Cited by 2 · see citing works
Alzahrani, N., Alshehri, A., Alshehri, A., & Johani, S. A. (2025) · Diagnostics · doi:10.3390/diagnostics15212699 · Cited by 1 · see citing works
Stewardship of Molecular Diagnostics in Transplant Viral Infections
Sugden, S., Reynoso, D., Mathew, R., & Loeffelholz, M. J. (2025) · Transplant Infectious Disease · doi:10.1111/tid.70140 · Cited by 1 · see citing works
Mok, T. H., Lam, L. M. M., & Cheung, C. Y. (2024) · CEN Case Reports · doi:10.1007/s13730-024-00939-2 · Cited by 1 · see citing works
Hauser, J., Powell, E. A., & Babady, N. E. (2025) · doi:10.1002/9781683674597.ch1
Introduction to Molecular Diagnosis of Meningitis
Sharma, V. K., Raina, S., Lakhera, S., & Sangwan, J. (2025) · Medical virology · doi:10.1007/978-981-96-7097-0_7
Misleading detection of herpes simplex virus type 1 in a patient with paraneoplastic encephalitis
Lischer, M., Trendelenburg, M., Yaldizli, Ö., Avramiotis, N. S., Marti, G., & Vital, A. (2025) · European Journal of Case Reports in Internal Medicine · doi:10.12890/2025_005705
Li, H., Gui, P., Li, X., Lin, Y., Ma, Z., Yu, H., & Ma, F. (2025) · Yeast · doi:10.1002/yea.70002
Viral meningoencephalitis: a focus on diagnostics
López, N., Cuesta, G., & Puerta‐Alcalde, P. (2025) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000001153 · Cited by 1 · see citing works
Self-citationZhang, D., Wang, J., Zhao, Z., Tie, Y., Wu, J., Jiao, S., Liu, X., Wang, Y., Gao, S., Zhao, M., et al. (2026) · Pathogens · doi:10.3390/pathogens15050456
Zhang, J., Qin, L., Liu, N., Zhang, F., & Jiang, Q. (2026) · Medicine · doi:10.1097/md.0000000000048455
Sberna, G., D’Arezzo, S., Valli, M. B., Nisii, C., Lalle, E., Selleri, M., Brillo, F., Palazzo, C. G., Venditti, C. C., Rotondo, C., et al. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2026.1853020
Busl, K. M., Ordway, N., & Sonneville, R. (2026) · Journal of Intensive Medicine · doi:10.1016/j.jointm.2026.06.005
Yaman, M., Odabaşi, F., & İlki, A. (2026) · Clinical and Experimental Health Sciences · doi:10.33808/clinexphealthsci.1982407
- Authors
- López, N., Cuesta, G., Rodríguez-Vega, S., Rosas, E., Chumbita, M., Casals-Pascual, C., Morata, L., Vergara, A., Bodro, M., Bosch, J., Herrera, S., Martínez, J. A., Mensa, J., Garcia-Vidal, C., Marcos, M. Á., Vila, J., Soriano, A., & Puerta-Alcalde, P.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- Hospital Universitario De Cabueñes (ES)
- Centro de Investigación Biomédica en Red (ES)
- ORCID
- Venue
- Infection
- Published
- 2023-07-29
- Volume
- 52
- Issue
- 1
- Pages
- 165-172
- ISSN
- 0300-8126 (ISSN-L)
- 1439-0973
- PMC
- PMC10810907
- OpenAlex
- W4385380208
- Cited by
- 21
- References
- 17
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 7
- FWCI
- 4.32
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Infection (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by)
- TECNALIA Publications (Fundación TECNALIA Research & Innovation) (submittedVersion, public-domain)
- Funders
- Instituto de Salud Carlos III (JR20/00012, PI21/00498, ICI21/00103)
- Universitat de Barcelona
- Topics
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- FilmArray Meningitis/Encephalitis panel, meningitis, encephalitis, cerebrospinal fluid, multiplex real-time PCR, diagnostic accuracy, false positives, herpes simplex virus type 1, false-negative results, pleocytosis, cerebrospinal fluid protein, predictive value, viral meningitis
- MeSH terms
- Encephalitis, Humans, Leukocytosis, Meningitis, Meningoencephalitis, Retrospective Studies, Multiplex Polymerase Chain Reaction, Real-Time Polymerase Chain Reaction
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
