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Evaluation of pathogen from the FilmArray meningitis/encephalitis panel and recommendations on atypical findings
Open accessAbstract
BACKGROUND: Infectious meningoencephalitis is a potentially fatal clinical condition that causes inflammation of the central nervous system secondary to the installation of different microorganisms. The FilmArray meningitis/encephalitis panel allows the simultaneous detection of 14 pathogens with results in about one hour. OBJECTIVE: This study is based on retrospectively evaluating the implementation of the FilmArray meningitis/encephalitis panel in a hospital environment, highlighting the general results and, especially, analyzing the consistency of the test results against the clinical and laboratory conditions of the patients. METHODS: Data were collected through the results reported by the BioFire FilmArray system software from the meningitis/encephalitis panel. The correlated laboratory tests used in our analysis, when available, included biochemical, cytological, direct and indirect microbiological tests. RESULTS: In the analyzed period, there were 496 samples with released results. Of the total of 496 samples analyzed, 88 (17.75%) were considered positive, and 90 pathogens were detected, and in 2 of these (2.27%) there was co-detection of pathogens. Viruses were the agents most frequently found within the total number of pathogens detected. Of the 496 proven samples, 20 (4.03%) were repeated, 5 of which were repeated due to invalid results, 6 due to the detection of multiple pathogens and 9 due to disagreement between the panel results and the other laboratory tests and/or divergence of the clinical-epidemiological picture. Of these 20 repeated samples, only 4 of them (20%) maintained the original result after repeating the test, with 16 (80%) being non-reproducible. The main factor related to the disagreement of these 16 samples during retesting was the detection of bacterial agents without any relationship with other laboratory tests or with the patients' clinical condition. CONCLUSION: In our study, simply reproducing tests with atypical results from the FilmArray meningitis/encephalitis panel proved, in most cases, effective and sufficient for interpreting these results.
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“The overall positivity rate of multiplex panels in our cohort was comparable to that reported in previous BioFire® FilmArray® studies,10,14-16 and positivity was notably higher in paediatric patients, confirming their higher diagnostic yield in children.10,15”
From Utility and clinical relevance of multiplex PCR panels for diagnosis of central nervous system infections (2026) · cites this paper as [16]
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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×
“1,2 Furthermore, the costs associated with these infections are considerable, both in the short term, linked to hospitalization and treatment costs, and in the long term, considering the possible productive losses of the affected individuals.”
BackgroundLeber, 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 1×
“10 Furthermore, to mitigate these possibilities of incorrect or inconclusive results, based on our fi ndings and the experience of other studies, we created a panel with recommendations to be taken into account when using and interpreting the test ( ► Chart 2 ).”
MethodTansarli, G. S., & Chapin, K. C. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2019.11.016 · Cited by 263 · cited 1×
“21 However, after judging the test results in conjunctionwithclinical information and/or after checking with other laboratory tests, the percentage of false-positive samples dropped to 4%, making clear the importance of reviewing the results and the relevance and frequency of false-positive samples.”
BackgroundRadmard, 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 127 · cited 1×
“13 If it were actually considered positive and clinically relevant, its prevalence would have surpassed that of the Enterovirus in the mentioned study.”
BackgroundGomez, C. A., Pinsky, B. A., Liu, A., & Banaei, N. (2017) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofw245 · Cited by 53 · cited 1×
“18 On that occasion, when the test was repeated on the remaining sample, the panel result was negative and another conventional single-plex PCR test performed separately for HSV-1 was also negative, unlike the PCR test for M tuberculosis which gave a positive result.”
ResultBoudet, 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
State-of-the-Art Microbiologic Testing for Community-Acquired Meningitis and Encephalitis
Polage, C. R., & Cohen, S. H. (2016) · Journal of Clinical Microbiology · doi:10.1128/jcm.00289-16 · Cited by 43
Tarai, B., & Das, P. (2019) · Neurological Sciences · doi:10.1007/s10072-018-3584-y · Cited by 41
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Cited by
Sorted by citations
Gürler, M., Karaoğlu, Ç., Yurtcu, E. E., Us, E., & Karahan, Z. C. (2026) · The Indian Journal of Medical Research · doi:10.25259/ijmr_2107_2025
Metadata
- Authors
- Côrtes, L. G. F., Maldonado, M. M., Koga, P. C. M., Santiago, K. A. D. S., Fernandes, G. B. P., Maluf, M. M., & Martino, M. D. V.
- Affiliations
- Hospital Israelita Albert Einstein, Laboratório Clínico, São Paulo SP, Brazil.
- Hospital Israelita Albert Einstein (BR)
- Corresponding author
- Martino, Marinês Dalla Valle
- ORCID
- Venue
- Arquivos de Neuro-Psiquiatria
- Publisher
- Georg Thieme Verlag KG
- Published
- 2024-01
- Volume
- 82
- Issue
- 01
- Pages
- 001-008
- ISSN
- 0004-282X (ISSN-L)
- 1678-4227
- PMC
- PMC10843913
- OpenAlex
- W4392729241
- Cited by
- 2
- References
- 8
- Citations by year
- 2024: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Arquivos de Neuro-Psiquiatria (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Microbiology (medical) › Bacterial Identification and Susceptibility Testing
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- FilmArray Meningitis/Encephalitis panel, multiplex PCR, test reproducibility, false positives, viral pathogens, pathogenic bacteria, central nervous system infection, molecular diagnosis
- MeSH terms
- Encephalitis, Humans, Inflammation, Meningitis, Retrospective Studies, Viruses
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- Côrtes, L. G. F., Maldonado, M. M., Koga, P. C. M., Santiago, K. A. D. S., Fernandes, G. B. P., Maluf, M. M., & Martino, M. D. V. (2024). Evaluation of pathogen from the FilmArray meningitis/encephalitis panel and recommendations on atypical findings. Arquivos de Neuro-Psiquiatria. https://doi.org/10.1055/s-0044-1779035
