Comparison of cerebrospinal fluid results analysis against meningitis pathogens in meningitis patients

Abstract

Introduction: Meningitis is a major contributor to global mortality and morbidity rates. The rapid diagnosis of its etiology is crucial. Cerebrospinal fluid (CSF) analysis plays a key role in this process. This study aims to compare CSF analysis results with the Biofire Filmarray ME panel to expedite and simplify the diagnosis of meningitis etiology. Method: Using an observational analytical cross-sectional design, the study was conducted over 4 months. CSF samples were collected from multiple hospitals. The CSF analysis involved flow cytometry using Sysmex XN 1000 and Dimension EXL platforms. The Biofire Filmarray ME panel employed multiplex PCR technology. Result: Of the 30 samples, 83.3% exhibited clear appearance, 93.3% lacked clots, and 83.3% were clear in color. Increased cell counts were noted in 56.7% of samples, elevated protein levels in 43.3%, and normal glucose levels in 56.7%. CSF analysis interpretations indicated 70% normal, 3.3% viral infection, and 26.7% bacterial infection. The Biofire Filmarray ME panel results showed 96.7% negatives and 3.3% positive for Cytomegalovirus. Comparing CSF analysis with Biofire Filmarray ME panel results using McNemar's test indicated significant differences. The study highlighted the quality assurance of CSF analysis, challenges of antibiotic use, low prevalence of pathogens detected by the Biofire Filmarray, and the potential for false negatives due to untargeted pathogens. Conclusion: In conclusion, this study provides insights into CSF analysis and its comparison with the Biofire Filmarray ME panel. However, limitations include the Biofire Filmarray's inability to detect all pathogens and absence of certain data during CSF sampling. Further improvements are needed to enhance accuracy in meningitis diagnosis..