Multiplex PCR reveals high prevalence of enterovirus and HHV6 in acellular paediatric cerebrospinal fluid samples

Lumley, Sheila F; Pritchard, Dave; Dutta, Atanu Kumar; Matthews, Philippa C.; Cann, K. J.

doi:10.1016/j.jinf.2018.05.008

Cited by 26 publications

(20 citation statements)

References 8 publications

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“…In concordance with other studies [6,7,[9][10][11][12][34][35][36][37][38], S. pneumoniae (17/30) was the most frequent bacterial pathogen detected by the FilmArray ME assay.…”

Section: Discussionsupporting

confidence: 91%

“…Conventional assays confirmed presence of VZV and H. influenzae, whereas HHV-6 was not found by specific PCR Using this selection criteria we selected 171/4623 CSF specimens for additional syndromic molecular testing. Overall we observed positive results in 56/171 (32%), which is higher than in other published studies [6,7,[9][10][11][12][34][35][36][37][38] and substantially higher compared to the multicenter evaluation study [6] and three other studies [7,32,33], that reported positivity rates of under 15% (p < 0.0001). In addition, we could increase the amount of bacterial pathogens to 53% of the specimens, again this is more than in other published studies that observed positive ranges for bacterial pathogens between 15 and 37% [6,7,32,33].…”

Section: Discussioncontrasting

confidence: 66%

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Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis

et al. 2020

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Background: Infectious meningitis is a serious disease and patient outcome relies on fast and reliable diagnostics. A syndromic panel testing approach like the FilmArray ME can accelerate diagnosis and therefore decrease the time to pathogen specific therapy. Yet, its clinical utility is controversial, mainly because of a remaining uncertainty in correct interpretation of results, limited data on its performance on clinical specimens and its relatively high costs. The aim of this study was to analyze clinical performance of the assay in a real life setting at a tertiary university hospital using a pragmatic and simple sample selection strategy to reduce the overall cost burden. Methods: Over a period of 18 months we received 4623 CSF samples (2338 hospitalizations, 1601 individuals). FilmArray ME analysis was restricted to CSF-samples with a high pretest probability of infectious meningitis, e.g. positive Gram-stain, samples in which leukocytes and/or bacteria were evident or urgent suspicion of infection was communicated by clinicians. N = 171 samples matched to our risk criteria and were subjected to FilmArray ME analysis. Those samples were also analyzed by reference methods: culture only (n = 45), PCR only (n = 20) or both methods (n = 106). Results: 56/171 (32.75%) were FilmArray ME positive. Bacterial pathogens were detected in 30/56 (53.57%), viral pathogens were detected in 27/56 (48.21%) and yeast DNA was detected in 1/56 (1.79%) of positive samples. Double detection occurred in 2/56 samples. In 52/56 (92.86%) FilmArray ME positive samples, results could be confirmed by the reference assays (sensitivity = 96.30%, specificity =96.58%). Conclusion: The FilmArray ME assay is a fast and reliable diagnostic tool for the management of infectious meningitis and can easily be implemented in routine diagnostic workflows. However, correlation of test results and underlying clinical symptoms requires experienced users and the awareness of potentially false negative or false positive results. Moreover, considering the need for antimicrobial susceptibility testing, the use of molecular tests as a stand-alone diagnostic cannot be recommended.

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“…In concordance with other studies [6,7,[9][10][11][12][34][35][36][37][38], S. pneumoniae (17/30) was the most frequent bacterial pathogen detected by the FilmArray ME assay.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 66%

Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In addition, we could increase the amount of bacterial pathogens to 53% of the specimens, again this is more than in other published studies that observed positive ranges for bacterial pathogens between 15-37% [6,7,32,33]. Indeed, bacteria were the most abundant In concordance with other studies [6,7,[9][10][11][12][34][35][36][37][38], S. pneumoniae (17/30) In four samples, potentially false positive results of FilmArray ME panel occurred, including three samples tested positive for bacterial pathogens by multiplex PCR that remained culture negative.…”

Section: Discussionsupporting

confidence: 88%

“…Using this selection criteria we selected 171/4623 CSF specimens for additional syndromic molecular testing. Overall we observed positive results in 56/171 (32%), which is higher than in other published studies [6,7,[9][10][11][12][34][35][36][37][38] and substantially higher compared to the multicenter evaluation study [6] and three other studies [7,32,33], that reported positivity rates of under 15% (p<0.0001). In addition, we could increase the amount of bacterial pathogens to 53% of the specimens, again this is more than in other published studies that observed positive ranges for bacterial pathogens between 15-37% [6,7,32,33].…”

Section: Discussioncontrasting

confidence: 65%

Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis

Pfefferle

Martin

Aepfelbacher

et al. 2020

Preprint

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“…Given the costs of the test, it is currently unclear if all CSF samples with suspected neuroinfection or only those with CSF pleocytosis should undergo testing with the panel. A paediatric study showed that EV may present without pleocytosis in infants suggesting that it may be cost-effective in a universal approach with the ME panel by reducing the number of studies and days of hospitalisation [17].…”

Section: Discussionmentioning

confidence: 99%

Impact of the Film Array Meningitis/Encephalitis panel in adults with meningitis and encephalitis in Colombia

et al. 2020

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The Biofire® Film Array Meningitis Encephalitis (FAME) panel can rapidly diagnose common aetiologies but its impact in Colombia is unknown. A retrospective study of adults with CNS infections in one tertiary hospital in Colombia. The cohort was divided into two time periods: before and after the implementation of the Biofire® FAME panel in May 2016. A total of 98 patients were enrolled, 52 and 46 were enrolled in the Standard of Care (SOC) group and in the FAME group, respectively. The most common comorbidity was human immunodeficiency virus infection (47.4%). The median time to a change in therapy was significantly shorter in the FAME group than in the SOC group (3 vs. 137.3 h, P < 0.001). This difference was driven by the timing to appropriate therapy (2.1 vs. 195 h, P < 0.001) by identifying viral aetiologies. Overall outcomes and length of stay were no different between both groups (P > 0.2). The FAME panel detected six aetiologies that had negative cultures but missed identifying one patient with Cryptococcus neoformans. The introduction of the Biofire FAME panel in Colombia has facilitated the identification of viral pathogens and has significantly reduced the time to the adjustment of empirical antimicrobial therapy.

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Multiplex PCR reveals high prevalence of enterovirus and HHV6 in acellular paediatric cerebrospinal fluid samples

Cited by 26 publications

References 8 publications

Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis

Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis

Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis

Impact of the Film Array Meningitis/Encephalitis panel in adults with meningitis and encephalitis in Colombia

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