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.

Abstract

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. 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. 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 2-17years, 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 35years. Cryptococcus neoformans was found in 7 cases. 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.