Skip to main content
Top
Published in: Neurological Sciences 1/2019

01-01-2019 | Original Article

FilmArray® meningitis/encephalitis (ME) panel, a rapid molecular platform for diagnosis of CNS infections in a tertiary care hospital in North India: one-and-half-year review

Authors: Bansidhar Tarai, Poonam Das

Published in: Neurological Sciences | Issue 1/2019

Login to get access

Abstract

Background

Acute meningitis and encephalitis (AME) is a syndrome of central nervous system (CNS) infections, which could lead to neurological damage and fatality. This study evaluates the multiplex FilmArray® ME Panel which is aimed to diagnose agents causing suspect CNS infections in north India.

Methods

A total number of 969 cerebrospinal fluid (CSF) samples collected between August 2016 and January 2018 from patients who showed clinical symptoms of CNS infections were analyzed using the FilmArray® ME Panel. Also a comparison of molecular diagnosis and various laboratory and radiological findings for Streptococcus pneumoniae, Enterovirus and Cryptococcus neoformans positive cases was done.

Result

Out of the 969 CSF samples, 101 cases were found to be positive for viral (n = 55), bacterial (n = 38), fungal (n = 7), and poly-microbial (n = 1) agents. Out of the 55 viral positive cases, the most detected pathogen was Enterovirus (n = 23) with predominance in the age group of 2–17 years, followed by Varicella Zoster virus (n = 14) and HSV1(n = 9) cases. Streptococcus pneumoniae (n = 26) was found to be the predominant bacterial pathogen, of which 17 were detected in the age group above 35 years. Cryptococcus neoformans was found in 7 cases.

Conclusion

The FilmArray® ME Panel aids in rapid detection of 14 pathogens directly from CSF. When compared to gram stain, culture, antigen detection, and CSF biochemical analysis, the FilmArray® ME Panel has detected more cases, some of which are difficult to diagnose by conventional methods. This rapid technology will help the clinicians in case of early patient management, outcomes and provide aid in antimicrobial stewardship.
Literature
2.
go back to reference Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, Harrison LH, Farley MM, Reingold A, Bennett NM, Craig AS, Schaffner W, Thomas A, Lewis MM, Scallan E, Schuchat A (2011) Bacterial meningitis in the United States, 1998–2007. N Engl J Med 364:2016–2025. https://doi.org/10.1056/NEJMoa1005384 CrossRefPubMed Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, Harrison LH, Farley MM, Reingold A, Bennett NM, Craig AS, Schaffner W, Thomas A, Lewis MM, Scallan E, Schuchat A (2011) Bacterial meningitis in the United States, 1998–2007. N Engl J Med 364:2016–2025. https://​doi.​org/​10.​1056/​NEJMoa1005384 CrossRefPubMed
6.
go back to reference Bohr V, Rasmussen N, Hansen B, Kjersem H, Jessen O, Johnsen N, Kristensen HS (1983) 875 cases of bacterial meningitis: diagnostic procedures and the impact of preadmission antibiotic therapy. Part III of a three-part series. J Inf Secur 7:193–202 Bohr V, Rasmussen N, Hansen B, Kjersem H, Jessen O, Johnsen N, Kristensen HS (1983) 875 cases of bacterial meningitis: diagnostic procedures and the impact of preadmission antibiotic therapy. Part III of a three-part series. J Inf Secur 7:193–202
7.
go back to reference Nigrovic LE, Malley R, Macias CG, Kanegaye JT, Moro-Sutherland DM, Schremmer RD, Schwab SH, Agrawal D, Mansour KM, Bennett JE, Katsogridakis YL, Mohseni MM, Bulloch B, Steele DW, Kaplan RL, Herman MI, Bandyopadhyay S, Dayan P, Truong UT, Wang VJ, Bonsu BK, Chapman JL, Kuppermann N (2008) Effect of antibiotic retreatment on cerebrospinal fluid profiles of children with bacterial meningitis. Pediatrics 122:726–730. https://doi.org/10.1542/peds.2007-3275 CrossRefPubMed Nigrovic LE, Malley R, Macias CG, Kanegaye JT, Moro-Sutherland DM, Schremmer RD, Schwab SH, Agrawal D, Mansour KM, Bennett JE, Katsogridakis YL, Mohseni MM, Bulloch B, Steele DW, Kaplan RL, Herman MI, Bandyopadhyay S, Dayan P, Truong UT, Wang VJ, Bonsu BK, Chapman JL, Kuppermann N (2008) Effect of antibiotic retreatment on cerebrospinal fluid profiles of children with bacterial meningitis. Pediatrics 122:726–730. https://​doi.​org/​10.​1542/​peds.​2007-3275 CrossRefPubMed
8.
go back to reference Gutierrez M, Emmanuel PJ (2018) Expanding molecular diagnostics for central nervous system infections. Adv Pediatr Infect Dis 65(1):209–227 Gutierrez M, Emmanuel PJ (2018) Expanding molecular diagnostics for central nervous system infections. Adv Pediatr Infect Dis 65(1):209–227
9.
go back to reference Ramanan P, Bryson AL, Binnicker MJ, Pritt BS, Patel R (2017) Syndromic panel-based testing in clinical microbiology. Clin Microbiol Rev 31(1) Ramanan P, Bryson AL, Binnicker MJ, Pritt BS, Patel R (2017) Syndromic panel-based testing in clinical microbiology. Clin Microbiol Rev 31(1)
11.
go back to reference Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS Jr, Swartz MN (1993) Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 328:21–28CrossRef Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS Jr, Swartz MN (1993) Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 328:21–28CrossRef
12.
go back to reference Dash AP, Bhatia R, Sunyoto T, Mourya DT (2013) Emerging and re-emerging arboviral diseases in Southeast Asia. J Vector Borne Dis 50:77–84PubMed Dash AP, Bhatia R, Sunyoto T, Mourya DT (2013) Emerging and re-emerging arboviral diseases in Southeast Asia. J Vector Borne Dis 50:77–84PubMed
13.
go back to reference WHO (2012) Establishing surveillance for acute meningitis and encephalitis syndromes through expansion of poliomyelitis and measles surveillance networks in Bangladesh, China and India, 2006–2008. Wkly Epidemiol Rec 87:513–519 WHO (2012) Establishing surveillance for acute meningitis and encephalitis syndromes through expansion of poliomyelitis and measles surveillance networks in Bangladesh, China and India, 2006–2008. Wkly Epidemiol Rec 87:513–519
15.
go back to reference World Health Organization (2008) WHO recommended standards for surveillance of selected vaccine-preventable diseases. The Organization, Geneva World Health Organization (2008) WHO recommended standards for surveillance of selected vaccine-preventable diseases. The Organization, Geneva
17.
go back to reference Leber AL, Everhart K, Balada-Llasat J-M, Cullison J, Daly J, Holt S et al (2016) Multicenter evaluation of BioFire FilmArray meningitis/encephalitis panel for detection of bacteria, viruses, and yeast in cerebrospinal fluid specimens. J Clin Microbiol 54(9):2251–2261CrossRef Leber AL, Everhart K, Balada-Llasat J-M, Cullison J, Daly J, Holt S et al (2016) Multicenter evaluation of BioFire FilmArray meningitis/encephalitis panel for detection of bacteria, viruses, and yeast in cerebrospinal fluid specimens. J Clin Microbiol 54(9):2251–2261CrossRef
18.
go back to reference Naccache SN, Lustestica M, Fahit M, Mestas J, Dien BJ (2018) One year in the life of a rapid syndromic panel for meningitis/encephalitis: a pediatric tertiary care facility’s experience. J Clin Microbiol 56(5) Naccache SN, Lustestica M, Fahit M, Mestas J, Dien BJ (2018) One year in the life of a rapid syndromic panel for meningitis/encephalitis: a pediatric tertiary care facility’s experience. J Clin Microbiol 56(5)
19.
go back to reference Marchioni E, Ravaglia S, Piccolo G, Furione M, Zardini E, Franciotta D, Alfonsi E, Minoli L, Romani A, Todeschini A, Uggetti C, Tavazzi E, Ceroni M (2005) Postinfectious inflammatory disorders: subgroups based on prospective follow-up. Neurology 65(7):1057–1065CrossRef Marchioni E, Ravaglia S, Piccolo G, Furione M, Zardini E, Franciotta D, Alfonsi E, Minoli L, Romani A, Todeschini A, Uggetti C, Tavazzi E, Ceroni M (2005) Postinfectious inflammatory disorders: subgroups based on prospective follow-up. Neurology 65(7):1057–1065CrossRef
20.
go back to reference Marchioni E, Ravaglia S, Montomoli C, Tavazzi E, Minoli L, Baldanti F, Furione M, Alfonsi E, Bergamaschi R, Romani A, Piccolo L, Zardini E, Bastianello S, Pichiecchio A, Ferrante P, Delbue S, Franciotta D, Bono G, Ceroni M (2013) Postinfectious neurologic syndromes: a prospective cohort study. Neurology 80(10):882–889CrossRef Marchioni E, Ravaglia S, Montomoli C, Tavazzi E, Minoli L, Baldanti F, Furione M, Alfonsi E, Bergamaschi R, Romani A, Piccolo L, Zardini E, Bastianello S, Pichiecchio A, Ferrante P, Delbue S, Franciotta D, Bono G, Ceroni M (2013) Postinfectious neurologic syndromes: a prospective cohort study. Neurology 80(10):882–889CrossRef
21.
go back to reference Mastrangelo F et al (2018) J Biol Regul Homeost Agents 32(2):195–198 Low-grade chronic inflammation mediated by mast cells in fibromyalgia: role of IL-37PubMed Mastrangelo F et al (2018) J Biol Regul Homeost Agents 32(2):195–198 Low-grade chronic inflammation mediated by mast cells in fibromyalgia: role of IL-37PubMed
23.
go back to reference Hussein AS, Shafran SD (2000) Acute bacterial meningitis in adults. A 12-year review. Medicine (Baltimore) 79:360–368CrossRef Hussein AS, Shafran SD (2000) Acute bacterial meningitis in adults. A 12-year review. Medicine (Baltimore) 79:360–368CrossRef
24.
go back to reference Tajiri T, Tate G, Enosawa T, Acita H, Ohine N, Masunaga A et al (2007) Clinicopathological findings in fulminant-type pneumococcal infection: report of three autopsy cases. Pathol Int 57:606–612CrossRef Tajiri T, Tate G, Enosawa T, Acita H, Ohine N, Masunaga A et al (2007) Clinicopathological findings in fulminant-type pneumococcal infection: report of three autopsy cases. Pathol Int 57:606–612CrossRef
25.
go back to reference Newland A, Provan D, Myint S (2005) Preventing severe infection after splenectomy. BMJ 331:417–418CrossRef Newland A, Provan D, Myint S (2005) Preventing severe infection after splenectomy. BMJ 331:417–418CrossRef
26.
go back to reference Kupila L, Vuorinen T, Vainionpää R, Hukkanen V, Marttila RJ, Kotilainen P (2006) Aetiology of aseptic meningitis and encephalitis in an adult population. Neurology 66:75–80CrossRef Kupila L, Vuorinen T, Vainionpää R, Hukkanen V, Marttila RJ, Kotilainen P (2006) Aetiology of aseptic meningitis and encephalitis in an adult population. Neurology 66:75–80CrossRef
27.
go back to reference Bhatt GC, Sharma T Clinical profile and outcome of Japanese encephalitis in children admitted with acute encephalitis syndrome Bhatt GC, Sharma T Clinical profile and outcome of Japanese encephalitis in children admitted with acute encephalitis syndrome
28.
go back to reference Suri V, Narang U, Bhalla A Viral encephalitis in India: management Update Suri V, Narang U, Bhalla A Viral encephalitis in India: management Update
29.
go back to reference Wu-Chung Shen, Hsiu-Hui Chiu, Kuan-Chih Chow, and Chang-Hai Tsai, MR imaging findings of enteroviral encephalomyelitis: an outbreak in Taiwan Wu-Chung Shen, Hsiu-Hui Chiu, Kuan-Chih Chow, and Chang-Hai Tsai, MR imaging findings of enteroviral encephalomyelitis: an outbreak in Taiwan
30.
go back to reference Goren A, Mccoy J, Kovacevic M, Situm M, Lonky N (2017) Potential risk of developing herpes simplex encephalitis in patients treated with sildenafil following primary exposure to genital herpes. J Biol Regul Homeost Agents 31(3):679–682PubMed Goren A, Mccoy J, Kovacevic M, Situm M, Lonky N (2017) Potential risk of developing herpes simplex encephalitis in patients treated with sildenafil following primary exposure to genital herpes. J Biol Regul Homeost Agents 31(3):679–682PubMed
33.
go back to reference BioFire Diagnostics (2015) FilmArray meningitis/encephalitis (ME) panel instruction booklet RF-Y-ASY-0118. BioFire Diagnostics, Salt Lake City BioFire Diagnostics (2015) FilmArray meningitis/encephalitis (ME) panel instruction booklet RF-Y-ASY-0118. BioFire Diagnostics, Salt Lake City
34.
go back to reference Parida M, Dash PK, Tripathi NK, Ambuj, Sannarangaiah S, Saxena P et al (2006) Japanese encephalitis outbreak, India, 2005. Emerg Infect Dis 12:1427–1430CrossRef Parida M, Dash PK, Tripathi NK, Ambuj, Sannarangaiah S, Saxena P et al (2006) Japanese encephalitis outbreak, India, 2005. Emerg Infect Dis 12:1427–1430CrossRef
Metadata
Title
FilmArray® meningitis/encephalitis (ME) panel, a rapid molecular platform for diagnosis of CNS infections in a tertiary care hospital in North India: one-and-half-year review
Authors
Bansidhar Tarai
Poonam Das
Publication date
01-01-2019
Publisher
Springer Milan
Published in
Neurological Sciences / Issue 1/2019
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-018-3584-y

Other articles of this Issue 1/2019

Neurological Sciences 1/2019 Go to the issue