The Evaluation of the Diagnostic Performance of the BioFire FilmArray Meningitis/Encephalitis Panel in Children: A Retrospective Multicenter Study
Abstract
Abstract Objective Acute bacterial meningitis (ABM) declined after implementing conjugate Haemophilus influenzae type B and the pneumococcal vaccines worldwide. However, it still contributes to significant morbidity and mortality. The Biofire FilmArray Meningitis Encephalitis (FAME) panel can rapidly diagnose common bacterial and viral pathogens. Several studies suggested that the use of FAME may accelerate diagnosis and decrease the time to pathogen-specific therapy. However, the clinical utility is still controversial due to scarce data and relatively high costs. Therefore, we aimed to evaluate the diagnostic performance of FAME in children. Methods A retrospective multicenter cross-sectional study was conducted to evaluate FAME in diagnosing ABM in children with a suspected central nervous system infection between January 2017 and May 2021. Results This study consisted of 179 children diagnosed with central nervous system infection who had parallel testing done using FAME and traditional microbiological diagnostic methods. Twenty-two FAME results were positive; 8 (36.3%) were bacterial pathogens and 14 (53.7%) were viral pathogens. The most common viral pathogen was human herpesvirus 6 (n = 6; 27.2%), followed by herpes simplex virus 1 (n = 4; 18.1%), Enterovirus spp. (n = 2; 9%), Parechovirus (n = 2; 9%), and Cytomegalovirus (n = 1; 4.5%). Bacterial pathogens included S. pneumoniae (n = 3; 13.6%), H. influenzae (n = 3; 13.6%), Neisseria meningitidis (n = 1; 4.5%), and Streptococcus agalactiae (n = 1; 4.5%). Bacterial culture confirmed S. pneumoniae infection in only 1 of 8 (12.5%) patients, while 7 of 8 bacterial meningitis were only detected by FAME. Conclusion FAME may also help with diagnosis and pathogen identification in patients who have already had antibiotics before cerebrospinal fluid collection. The use of FAME to detect infections quickly may minimize the improper use of medications, treatment duration, and the cost of hospitalization.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
In pediatric studies using PCR for etiologic diagnosis of meningoencephalitis, viral pathogens were detected in 79.7% of cases in Ayhan et al., 84.5% in Mizuno et al., and 53.7% in Bal et al.
“In pediatric studies using PCR for the etiologic diagnosis of meningoencephalitis, viral pathogens were detected in 79.7% of cases in the study by Ayhan et al.12, 84.5% in the study by Mizuno et al.13, and 53.7% in the study by Bal et al.14”
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 [13]
Studies from various countries report bacterial pathogen detection rates via multiplex PCR ranging from 15.5% to 23%.
“Studies from various countries report bacterial pathogen detection rates via multiplex PCR ranging from 15.5% to 23% 13, 20.”
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 [13]
In a multicenter pediatric study from Japan, parechovirus (45%) and EV (43%) were the most common causes of viral CNS infections, whereas a study from Türkiye found EV (23.5%), adenovirus (22%), and HHV-6 (22%) to be the most common; HSV-1 positivity in the latter study was 5.9%.
“In a multicenter pediatric study from Japan, parechovirus (45%) and EV (43%) were the most common causes of viral CNS infections, whereas a study from Türkiye found EV (23.5%), adenovirus (22%), and HHV-6 (22%) to be the most common,13, 18; HSV-1 positivity in the latter study was 5.9%.”
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 [13]
Cites
Venkatesan, A., Tunkel, A. R., Bloch, K. C., Lauring, A. S., Sejvar, J. J., Bitnun, A., Stahl, J. ‐., Mailles, A., DREBOT, M. A., Rupprecht, C. E., et al. (2013) · Clinical Infectious Diseases · doi:10.1093/cid/cit458 · Cited by 1,223 · see citing works
Tansarli, G. S., & Chapin, K. C. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2019.11.016 · Cited by 263 · see citing works
Liesman, 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
Acute Bacterial Meningitis in Infants and Children: Epidemiology and Management
Agrawal, S., & Nadel, S. (2011) · Pediatric Drugs · doi:10.2165/11593340-000000000-00000 · Cited by 99 · see citing works
Koelman, D. L. H., van Kassel, M. N., Bijlsma, M. W., Brouwer, M. C., van de Beek, D., & ENDE, A. V. D. (2020) · Clinical Infectious Diseases · doi:10.1093/cid/ciaa1774 · Cited by 88 · see citing works
Normative Cerebrospinal Fluid Profiles in Febrile Infants
Byington, C. L., Kendrick, J., & Sheng, X. (2011) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2010.07.022 · Cited by 80 · see citing works
BACTERIAL MENINGITIS BEYOND THE NEONATAL PERIOD
Feigin, R. D., & Cutrer, W. B. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-4044-6.50042-x · Cited by 75 · see citing works
Nakamura, T., Cohen, A. L., Schwartz, S., et al. (2021) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiab217 · Cited by 57 · see citing works
Infectious Meningitis and Encephalitis
Bystritsky, R. J., & Chow, F. C. (2021) · Neurologic Clinics · doi:10.1016/j.ncl.2021.08.006 · Cited by 56 · see citing works
Boudet, A., Pantel, A., Carles, M.-J., Boclé, H., Charachon, S., Enault, C., Stéphan, R., Cadot, L., Lavigne, J.-P., & Marchandin, H. (2019) · PLOS ONE · doi:10.1371/journal.pone.0223887 · Cited by 49 · see citing works
Precit, M. R., Yee, R., Pandey, U., Fahit, M., Pool, C., Naccache, S. N., & Dien Bard, J. (2020) · Journal of Clinical Microbiology · doi:10.1128/jcm.01592-19 · Cited by 39 · see citing works
Bridge, S., Hullsiek, K. H., Nerima, C., Evans, E. E., Nuwagira, E., Stadelman, A. M., Tran, T., Kim, G., Tadeo, K. K., Kwizera, R., et al. (2021) · Journal of Medical Mycology · doi:10.1016/j.mycmed.2021.101170 · Cited by 38 · 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
Pfefferle, S., Christner, M., Aepfelbacher, M., Lütgehetmann, M., & Rohde, H. (2020) · BMC Infectious Diseases · doi:10.1186/s12879-020-4904-4 · Cited by 36 · 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
Messacar, K., Gaensbauer, J. T., Birkholz, M., Palmer, C., Todd, J. K., Tyler, K. L., & Dominguez, S. R. (2020) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/j.diagmicrobio.2020.115085 · Cited by 20 · see citing works
Kobayashi, M., Abdul-Karim, A., Milucky, J., Zakariah, A., Leidner, A. J., Asiedu‐Bekoe, F., Opare, D. A., Eleeza, J. B., Ofosu, W. K., Walker, C., et al. (2021) · Vaccine · doi:10.1016/j.vaccine.2021.06.043 · Cited by 14 · see citing works
Acute Bacterial Meningitis Beyond the Neonatal Period
Panuganti, S. K., & Nadel, S. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-75608-2.00040-9 · Cited by 6 · see citing works
Barros Domingues, R., Mendes-Correa, M. C., Vilela de Moura Leite, F. B., Vega dos Santos, M., & Senne Soares, C. A. (2022) · Pediatric Emergency Care · doi:10.1097/pec.0000000000002462 · Cited by 4 · see citing works
Ahmed, S. S., Lessa, F. C., Coradin, H., Sánchez, J., Carvalho, M. D. G., Soda, E. A., Peña, C., Fernández, J., Cedano, D., Whitney, C. G., et al. (2021) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiab134 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
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
“In Türkiye, Ayhan et al. 12 reported a bacterial detection rate of 20.6%, and Bal et al. 14 reported a rate of 36.3%.”
Influential
- Authors
- Bal, A., Saz, E. U., Arslan, S. Y., Atik, S., Bayturan, S., Yurtseven, A., Gazi, H., Cicek, C., Kurugol, Z., & Bal, Z. S.
- Affiliations
- Manisa Celal Bayar University (TR)
- Division of Emergency Medicine, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
- Division of Infectious Disease, Department of Pediatrics, Medical School of Ege University, Izmir, Turkey
- Ege University (TR)
- Department of Microbiology, Medical School of Ege University, Izmir, Turkey
- Corresponding author
- Bal, Alkan
- Venue
- Journal of Pediatric Infectious Diseases
- Published
- 2022-09
- Volume
- 17
- Issue
- 05
- Pages
- 252-257
- ISSN
- 1305-7693 (ISSN-L)
- 1305-7707
- OpenAlex
- W4297518360
- Cited by
- 1
- References
- 20
- Citations by year
- 2023: 1
- FWCI
- 0.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Pediatric Infectious Diseases (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- acute bacterial meningitis, central nervous system infection, pediatric patients, molecular diagnosis, rapid pathogen detection, viral meningitis, Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Streptococcus agalactiae, herpes simplex virus, human herpesvirus 6, enterovirus, cerebrospinal fluid, diagnostic accuracy
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
