Clinical utility of the FilmArray meningitis/encephalitis panel in children at a tertiary center in South Korea

Park, Su Eun; Lim, Taek Jin; Nam, Sang Ook; Chang, Chulhun L.; Byun, Shin Yun; Ko, Ara; Kong, Jai-Yul; Cho, Jae Wook; Yeon, Gyu Min; Lee, Yun-Jin

doi:10.1016/j.braindev.2020.08.010

Cited by 9 publications

(9 citation statements)

References 26 publications

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“…Of 81 reports analysed, 47 dealt with the clinical presentation of HPeV meningeal infection [ 1 , 8 – 12 , 14 , 17 , 21 , 23 , 25 – 28 , 32 , 33 , 41 , 44 – 73 ].…”

Section: Discussionmentioning

confidence: 99%

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Human parechovirus meningitis in children: state of the art

Bozzola,

Barni,

Barone

et al. 2023

Ital J Pediatr

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Human Parechovirus is a common cause of infection occurring especially during the first years of life. It may present with a broad spectrum of manifestations, ranging from a pauci-symptomatic infection to a sepsis-like or central nervous system disease. Aim of this study is to explore the knowledge on Parechovirus meningitis. According to the purpose of the study, a systematic review of the literature focusing on reports on central nervous system. Parechovirus infection of children was performed following PRISMA criteria. Out of the search, 304 papers were identified and 81 records were included in the revision dealing with epidemiology, clinical manifestations, laboratory findings, imaging, therapy and outcome. Parechovirus meningitis incidence may vary all over the world and outbreaks may occur. Fever is the most common symptom, followed by other non-specific signs and symptoms including irritability, poor feeding, skin rash or seizures. Although several reports describe favourable short-term neurodevelopmental outcomes at discharge after Parechovirus central nervous system infection, a specific follow up and the awareness on the risk of sequelae should be underlined in relation to the reported negative outcome. Evidence seems to suggest a correlation between magnetic imaging resonance alteration and a poor outcome.

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“…Of 81 reports analysed, 47 dealt with the clinical presentation of HPeV meningeal infection [ 1 , 8 – 12 , 14 , 17 , 21 , 23 , 25 – 28 , 32 , 33 , 41 , 44 – 73 ].…”

Section: Discussionmentioning

confidence: 99%

“…Almost all reports showed that the youngest (under 3 months of age and in particular neonates) were the most affected patients. [ 9 – 12 , 14 , 21 , 23 , 26 – 28 , 32 , 33 , 59 – 62 , 64 – 68 , 70 ]. Of note, an exceptional adolescent onset was reported in an immunosuppressed 17-year-old girl [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Human parechovirus meningitis in children: state of the art

Bozzola,

Barni,

Barone

et al. 2023

Ital J Pediatr

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“…Fast, comprehensive, and sensitive multiplexed PCR for common pathogenic causes of meningitis and encephalitis is a useful addition to current strategies and has the potential to allow the safe withdrawal of antibacterial coverage. Previous studies have shown the potential benefits of this technique in identifying treatable pathogens and estimated that the median diagnosis time from collection to outcome was approximately 3 hours [9,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…The FA ME panel simultaneously detects 14 pathogens in the CSF, including six bacteria (Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus pneumoniae, and Streptococcus agalactiae), seven viruses (cytomegalovirus [CMV], enterovirus [EV], HSV-1, HSV-2, human herpesvirus [HHV]-6, human parechovirus [HPeV], varicella zoster virus [VZV]), and one fungus (Cryptococcus neoformans/gattii). Since the approval of the FA ME panel, many studies have reported its usefulness worldwide, yet only a few studies have evaluated clinical implementation in Asia, including Korea [8,9]. In Korea, the FA ME panel was available for only less than 1 year, but it has recently become possible to use this panel again.…”

Section: Introductionmentioning

confidence: 99%

Clinical Usefulness of a Multiplex Molecular Panel for Central Nervous System Infection: An 11-Month Experience at a Tertiary Center in Korea

Lee

Yang

et al. 2023

Ann Child Neurol

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Purpose: The purpose of our study was to evaluate the usefulness of the BiofireFilmArray Meningitis/Encephalitis (FA ME) panel and identify factors associated with positive FA ME panel results. Methods: We retrospectively analyzed the medical records of 129 patients (45 children, 84 adults) with central nervous system infections and FA ME panel test results. We compared the results of the FA ME panel and the diagnostic yield between pediatric and adult patients with positive and negative FA ME panel results. Positive FA ME panel results were compared with conventional microbiological testing. Results: Forty-three patients (33.3%) had positive results on the FA ME panel. The detected pathogens were enterovirus (n=17, 39.5%), varicella zoster virus (n=10, 23.3%), herpes simplex virus-2 (n=2, 16.3%), herpes simplex virus-1 (n=2, 4.7%), human parechoviruses (n=2), Cryptococcus neoformans/gattii (n=2), Streptococcus agalactiae (n=1, 2.3%), Streptococcus pneumoniae (n=1), and Haemophilus influenzae (n=1). The time to detection of the FA ME panel (4.9±6.6 hours) was significantly shorter than that of conventional culture (77.4±48.2 hours) (P=0.005). Fever was more common in the positive FA ME group than in the negative FA ME group (81.4% vs. 41.9%) and in pediatric patients than in the adult patients (93.3% vs. 34.5%) (P<0.001 for both). The detection rate of the FA ME panel was higher in pediatric patients than in adult patients (55.8% vs. 22.6%, P<0.001). Conclusion: The FA ME panel improves the diagnostic rate in patients with suspected central nervous system infections, with potential favorable implications for the quality of management and prognosis.

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“…The main aetiology of CNS infections was viral, as described in study results by S.E. Park [ 25 ]. However, the overall positivity rate in this study was 46.4%, almost double that observed in our study (24.1%), which may be explained by the difference in clinical criteria between medical teams performing lumbar punctures in children.…”

Section: Discussionmentioning

confidence: 99%

FilmArray® Meningoencephalitis panel in the diagnosis of central nervous system infections: stewardship and cost analysis in a paediatric hospital in Chile

et al. 2022

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Background Central nervous system (CNS) infection has been an ongoing concern in paediatrics. The FilmArray® Meningoencephalitis (FAME) panel has greater sensitivity in identifying the aetiology of CNS infections. This study’s objective was to compare the aetiological identification and hospitalization costs among patients with suspected CNS infection before and after the use of FAME. Methods An analytical observational study was carried out using a retrospective cohort for the pre-intervention (pre-FAME use) period and a prospective cohort for the post-intervention (post-FAME use) period in children with suspected CNS infection. Results A total of 409 CSF samples were analysed, 297 pre-intervention and 112 post-intervention. In the pre-intervention period, a total of 85.5% of patients required hospitalization, and in the post-intervention period 92.7% required hospitalization (p < 0.05). Median of ICU days was significantly lower in the post-intervention period than it was in the pre-intervention period. The overall positivity was 9.4 and 26.8%, respectively (p < 0.001). At ages 6 months and below, we found an increase in overall positivity from 2.6 to 28.1%, along with an increased detection of viral agents, S. agalactiae, S. pneumoniae, and N. meningitidis. The use of this diagnostic technology saved between $2916 and $12,240 USD in the cost of ICU bed-days. FAME use provided the opportunity for more accurate aetiological diagnosis of the infections and thus the provision of adequate appropriate treatment. Conclusions The cost/benefit ratio between FAME cost and ICU bed-day cost savings is favourable. Implementation of FAME in Chilean public hospitals saves public resources and improves the accuracy of aetiological diagnosis.

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Clinical utility of the FilmArray meningitis/encephalitis panel in children at a tertiary center in South Korea

Cited by 9 publications

References 26 publications

Human parechovirus meningitis in children: state of the art

Human parechovirus meningitis in children: state of the art

Clinical Usefulness of a Multiplex Molecular Panel for Central Nervous System Infection: An 11-Month Experience at a Tertiary Center in Korea

FilmArray® Meningoencephalitis panel in the diagnosis of central nervous system infections: stewardship and cost analysis in a paediatric hospital in Chile

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