Poster Presentation Australian Society for Microbiology Annual Scientific Meeting 2018

One hour detection of clinically significant pathogens from cerebrospinal fluid using the BioFire FilmArray® Meningitis/Encephalitis Panel (#305)

Catherine Janto 1 , Rifky Balgahom 1 , Harsha Samarasekara 1 , James Branley 1 2
  1. Department of Microbiology - Nepean Hospital, NSW Health Pathology, Sydney, NSW, Australia
  2. Infectious Diseases and Microbiology, University of Sydney, Sydney, NSW, Australia

Objective

Meningitis and encephalitis are life threatening conditions which can have serious consequences if not managed early. This study evaluated the effectiveness of the BioFire FilmArray® Meningitis/Encephalitis (ME) Panel (BioMérieux) to provide simultaneous rapid nucleic acid detection of 14 pathogens in cerebrospinal fluid (CSF), including herpes simplex virus 1 (HSV-1), herpes simplex virus 2 (HSV-2), human herpes virus 6 (HHV-6), varicella-zoster virus (VZV), enterovirus (EV), cytomegalovirus (CMV), human parechovirus (HPeV), Neisseria meningitidis, Streptococcus pneumoniae, Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Streptococcus agalactiae (GBS), and Cryptococcus neoformans/gattii.

Methods

A total of 126 CSF samples were included in this study and tested on the FilmArray® ME Panel according to the manufacturer’s instructions. Specimens also underwent routine bacterial culture, and multiplex polymerase chain reaction (PCR) testing using the AusDiagnostics CSF assay and results compared. 

Results

The FilmArray® ME Panel detected at least one positive target in 52% (66/126) of specimens tested. Of the targets comparable to the AusDiagnostics CSF assay (HSV-1, HSV-2, VZV, EV, HPeV, N. meningitidis, S. pneumoniae, H. influenzae, L. monocytogenes, and C. neoformans/gattii), the ME Panel had 98% (124/126) correlation with the reference tests. All targets demonstrated 100% sensitivity and 100% specificity, with the exception of HSV-2 (2 false positive) and C. neoformans/gattii (1 false negative). HHV-6 was detected in 4 specimens and confirmed positive by a reference laboratory.

Conclusion

The BioFire FilmArray® ME Panel is highly sensitive and specific assay that provides results in approximately 1 hour. These results were available approximately 24 hours earlier compared to the routine AusDiagnostics CSF assay. Further evaluation is required for CMV, HHV-6, GBS, and E. coli K1 to assess clinical sensitivity and specificity. The ability to obtain a rapid result may have the potential to allow for early administration of targeted therapy, reducing hospital stay, associated costs and most importantly has the potential to save lives.