Evaluation of the FilmArray Meningitis/Encephalitis Panel for Detection of Pathogenic Microorganisms in Cerebrospinal Fluid Specimens

Background: Infectious meningitis and encephalitis are neurological emergencies that necessitate rapid diagnosis and treatment. Prompt initiation of empirical antimicrobials is common practice in suspected cases. However, swifter definite diagnosis and an earlier start of definitive treatment may improve outcomes. We compared the BioFire FilmArray Meningitis/Encephalitis (ME) Panel, a multiplex polymerase chain reaction test, with conventional standard methods of diagnosing infectious meningitis and encephalitis.Subjects and methods: We retrospectively studied 20 patients in whom meningitis or encephalitis was diagnosed according to clinical symptoms and laboratory findings between January 2018 and December 2019 at our institution. The results of pathogen diagnosis by the FilmArray ME Panel were compared with those of conventional methods.Results: The median age of the patients was 39 years (range, 23 to 85 years), and 13 (65%) were women. The FilmArray ME Panel identified the following pathogens: herpes simplex virus (HSV)-1 in two patients, HSV-2 in one, varicella-zoster virus (VZV) in four, Streptococcus pneumoniae in three, and Cryptococcus neoformans in one. This test detected additional pathogens in one patient with S. pneumoniae and in one with VZV, whereas the conventional methods did not. The median time to pathogen identification was 2 h with the FilmArray ME Panel but 4 days with conventional methods.Conclusion: Our findings suggest that the FilmArray ME Panel can detect and identify the most common pathogens faster and more sensitively than can conventional methods. This new method would thus help improve clinical outcomes through definitive diagnosis and treatment.