Rapid Diagnostic Tests for Meningitis and Encephalitis—BioFire

Abstract

Meningitis and encephalitis (ME) are important causes of morbidity and mortality worldwide. Patients suspected of having ME are often hospitalized and started on empiric antimicrobial treatment, because of the potential adverse consequences of delaying the diagnosis or treatment. Multiplexed polymerase chain reaction panels are one of several rapid diagnostic technologies that have the potential to overcome some of the limitations of conventional diagnostic methods for ME. The BioFire FilmArray Meningitis/Encephalitis Panel was the first Food and Drug Administration–cleared multiplex polymerase chain reaction for the evaluation of cerebrospinal fluid samples, able to identify 14 organisms in a single test reaction. This newer rapid diagnostic tool has an overall high sensitivity and specificity for the diagnosis of ME with a fast turnaround time and has the potential to improve resource utilization for patients presenting with suspicion of ME. However, further research is needed to determine its optimal use in the evaluation of patients with suspected ME.

Clinical Practice Guideline: Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old

“…Key references 66-70, 109-139 and there have been reports of both false-positive and false-negative results; Listeria is not in the panel. 118,119 An LP is not always successful. The rate of failure and/or traumatic LP in infants younger than 90 days is 20% to 50%; the rate of unsuccessful or dry LP is 25% to 40%; the rate of bloody LP is 10% to 30%.…”

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

“…56 However, downsides of existing RDTs include the absence of many pathogens in the test, the inability to distinguish between serotypes, and the inability to assess for antimicrobial resistance. 39 , 57 As the prevalence of antimicrobial resistance rises, especially in non-vaccine-preventable pathogens such as K pneumoniae , the need for global antimicrobial resistance surveillance systems grows. The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS), 58 which provides a standardised approach to collection, analysis, and sharing of clinical antimicrobial resistance data for surveillance, is expanding.…”

Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis

“…These benefits may translate into targeted and timely treatments to initiate, change, or dismantle an antimicrobial treatment, which in turn can be reflected in fewer adverse effects and shorter hospital stays. 42 , 43 , 44 , 45 , 46 , 47 However, the performance of the test varies among microorganisms and depends on the intended purpose. FA/ME seems better for ruling in, than for ruling out, the disease.…”