Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis

Rachael M. Liesman, Angela P. Strasburg, Angela K. Heitman, Elitza S. Theel, Robin Patel, Matthew J. Binnicker

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Rapid and accurate laboratory tests are important for the timely diagnosis and treatment of central nervous system infections. The FilmArray meningitis/ encephalitis (ME) panel (BioFire Diagnostics, Salt Lake City, UT) is an FDA-cleared, multiplex molecular panel that allows the detection of 14 pathogens (bacterial [n 6], viral [n 7], and fungal [n 1] pathogens) from cerebrospinal fluid (CSF). In this study, we evaluated the performance characteristics of the FilmArray ME panel using clinical, residual CSF samples (n 291) that tested positive by a routine method(s) (e.g., bacterial culture, individual real-time PCR assay) for a pathogen represented on the ME panel. Of note, a subset (n 76) of the CSF specimens was collected during the prevaccine era and had been characterized as positive for a bacterial pathogen. The FilmArray ME panel demonstrated an overall percent positive agreement (PPA) of 97.5% (78/80) for bacterial pathogens, 90.1% (145/161) for viruses, and 52% (26/50) for Cryptococcus neoformans/C. gattii. Despite the low overall agreement (52%) between the ME panel and antigen testing for detection of C. neoformans/C. gattii, the percent positive agreement of the FilmArray assay for C. neoformans/C. gattii was 92.3% (12/13) when the results were compared directly to the results of routine fungal smear or culture. The FilmArray ME panel offers a rapid (60-min), syndrome-based approach for the detection of select meningitis and encephalitis pathogens.

Original languageEnglish (US)
Article numbere01927
JournalJournal of Clinical Microbiology
Volume56
Issue number4
DOIs
StatePublished - Apr 1 2018

Fingerprint

Encephalitis
Meningitis
Cryptococcus neoformans
Cerebrospinal Fluid
Central Nervous System Infections
Infectious Encephalitis
Real-Time Polymerase Chain Reaction
Viruses
Antigens

Keywords

  • encephalitis
  • Meningitis
  • Multiplex molecular panel

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis. / Liesman, Rachael M.; Strasburg, Angela P.; Heitman, Angela K.; Theel, Elitza S.; Patel, Robin; Binnicker, Matthew J.

In: Journal of Clinical Microbiology, Vol. 56, No. 4, e01927, 01.04.2018.

Research output: Contribution to journalArticle

Liesman, Rachael M. ; Strasburg, Angela P. ; Heitman, Angela K. ; Theel, Elitza S. ; Patel, Robin ; Binnicker, Matthew J. / Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis. In: Journal of Clinical Microbiology. 2018 ; Vol. 56, No. 4.
@article{2f5c9811912c4bc885105d16bca788fa,
title = "Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis",
abstract = "Rapid and accurate laboratory tests are important for the timely diagnosis and treatment of central nervous system infections. The FilmArray meningitis/ encephalitis (ME) panel (BioFire Diagnostics, Salt Lake City, UT) is an FDA-cleared, multiplex molecular panel that allows the detection of 14 pathogens (bacterial [n 6], viral [n 7], and fungal [n 1] pathogens) from cerebrospinal fluid (CSF). In this study, we evaluated the performance characteristics of the FilmArray ME panel using clinical, residual CSF samples (n 291) that tested positive by a routine method(s) (e.g., bacterial culture, individual real-time PCR assay) for a pathogen represented on the ME panel. Of note, a subset (n 76) of the CSF specimens was collected during the prevaccine era and had been characterized as positive for a bacterial pathogen. The FilmArray ME panel demonstrated an overall percent positive agreement (PPA) of 97.5{\%} (78/80) for bacterial pathogens, 90.1{\%} (145/161) for viruses, and 52{\%} (26/50) for Cryptococcus neoformans/C. gattii. Despite the low overall agreement (52{\%}) between the ME panel and antigen testing for detection of C. neoformans/C. gattii, the percent positive agreement of the FilmArray assay for C. neoformans/C. gattii was 92.3{\%} (12/13) when the results were compared directly to the results of routine fungal smear or culture. The FilmArray ME panel offers a rapid (60-min), syndrome-based approach for the detection of select meningitis and encephalitis pathogens.",
keywords = "encephalitis, Meningitis, Multiplex molecular panel",
author = "Liesman, {Rachael M.} and Strasburg, {Angela P.} and Heitman, {Angela K.} and Theel, {Elitza S.} and Robin Patel and Binnicker, {Matthew J.}",
year = "2018",
month = "4",
day = "1",
doi = "10.1128/JCM.01927-17",
language = "English (US)",
volume = "56",
journal = "Journal of Clinical Microbiology",
issn = "0095-1137",
publisher = "American Society for Microbiology",
number = "4",

}

TY - JOUR

T1 - Evaluation of a commercial multiplex molecular panel for diagnosis of infectious meningitis and encephalitis

AU - Liesman, Rachael M.

AU - Strasburg, Angela P.

AU - Heitman, Angela K.

AU - Theel, Elitza S.

AU - Patel, Robin

AU - Binnicker, Matthew J.

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Rapid and accurate laboratory tests are important for the timely diagnosis and treatment of central nervous system infections. The FilmArray meningitis/ encephalitis (ME) panel (BioFire Diagnostics, Salt Lake City, UT) is an FDA-cleared, multiplex molecular panel that allows the detection of 14 pathogens (bacterial [n 6], viral [n 7], and fungal [n 1] pathogens) from cerebrospinal fluid (CSF). In this study, we evaluated the performance characteristics of the FilmArray ME panel using clinical, residual CSF samples (n 291) that tested positive by a routine method(s) (e.g., bacterial culture, individual real-time PCR assay) for a pathogen represented on the ME panel. Of note, a subset (n 76) of the CSF specimens was collected during the prevaccine era and had been characterized as positive for a bacterial pathogen. The FilmArray ME panel demonstrated an overall percent positive agreement (PPA) of 97.5% (78/80) for bacterial pathogens, 90.1% (145/161) for viruses, and 52% (26/50) for Cryptococcus neoformans/C. gattii. Despite the low overall agreement (52%) between the ME panel and antigen testing for detection of C. neoformans/C. gattii, the percent positive agreement of the FilmArray assay for C. neoformans/C. gattii was 92.3% (12/13) when the results were compared directly to the results of routine fungal smear or culture. The FilmArray ME panel offers a rapid (60-min), syndrome-based approach for the detection of select meningitis and encephalitis pathogens.

AB - Rapid and accurate laboratory tests are important for the timely diagnosis and treatment of central nervous system infections. The FilmArray meningitis/ encephalitis (ME) panel (BioFire Diagnostics, Salt Lake City, UT) is an FDA-cleared, multiplex molecular panel that allows the detection of 14 pathogens (bacterial [n 6], viral [n 7], and fungal [n 1] pathogens) from cerebrospinal fluid (CSF). In this study, we evaluated the performance characteristics of the FilmArray ME panel using clinical, residual CSF samples (n 291) that tested positive by a routine method(s) (e.g., bacterial culture, individual real-time PCR assay) for a pathogen represented on the ME panel. Of note, a subset (n 76) of the CSF specimens was collected during the prevaccine era and had been characterized as positive for a bacterial pathogen. The FilmArray ME panel demonstrated an overall percent positive agreement (PPA) of 97.5% (78/80) for bacterial pathogens, 90.1% (145/161) for viruses, and 52% (26/50) for Cryptococcus neoformans/C. gattii. Despite the low overall agreement (52%) between the ME panel and antigen testing for detection of C. neoformans/C. gattii, the percent positive agreement of the FilmArray assay for C. neoformans/C. gattii was 92.3% (12/13) when the results were compared directly to the results of routine fungal smear or culture. The FilmArray ME panel offers a rapid (60-min), syndrome-based approach for the detection of select meningitis and encephalitis pathogens.

KW - encephalitis

KW - Meningitis

KW - Multiplex molecular panel

UR - http://www.scopus.com/inward/record.url?scp=85044760156&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044760156&partnerID=8YFLogxK

U2 - 10.1128/JCM.01927-17

DO - 10.1128/JCM.01927-17

M3 - Article

C2 - 29436421

AN - SCOPUS:85044760156

VL - 56

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

SN - 0095-1137

IS - 4

M1 - e01927

ER -