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Evaluation of FilmArray ME panel for the rapid diagnosis of meningitis–encephalitis in emergency departments

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Abstract

To assess the impact of a rapid diagnostic system based on nucleic acid amplification techniques (FilmArray ME) on the diagnosis and treatment of patients with meningitis or encephalitis admitted to our emergency department. Between November 2016, and June 2019 we studied 79 samples of cerebrospinal fluid from patients admitted to our emergency department with suspected diagnoses of meningitis or encephalitis. FilmArray ME panel was used routinely in addition to conventional laboratory methods for the identification of microorganisms in cerebrospinal fluid samples (CSF). A total of 46 (58%) patients had clinical and CSF results suggestive of meningitis or encephalitis, and 24 (30%) had a confirmed microbiological diagnosis. Patients' mean age was 41 years (range 2 months to 90 years) and 56% were male. Four patients had been partially treated with antibiotics. FilmArray ME identified 23 cases (1 fungal, 11 bacterial, and 11 viral). Gram staining showed microorganisms in 5 cases (1 fungal, 4 bacterial), and conventional microbiology cultures identified 8 cases (1 fungal and 7 bacterial). The time difference (95% confidence interval) between FilmArray ME and cerebrospinal fluid culture results was 3.2 days (95% CI 2.7–3.7; P < 0.001). FilmArray ME results induced modifications in antimicrobial treatment in 27 (59%) patients. The FilmArray ME panel provided a fast and reliable result in a large proportion of patients, even in those patients with culture-negative bacterial meningitis. Use of FilmArray ME can contribute to antimicrobial stewardship.

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Funding

This work has not received funding from public or private entities, research, or foundations.

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Authors and Affiliations

  1. Departamento de Medicina Interna, Hospital Marina Baixa, Av Alcalde Jaime Botella Mayor s/n, 03570, Villajoyosa, Alicante, Spain

    Javier Ena, Roser Navarro-Soler & David de Haedo-Sanchez

  2. Departamento de Urgencias, Hospital Marina Baixa, Villajoyosa, Alicante, Spain

    Raisa Goretti Afonso-Carrillo, Miriam Bou-Collado & Maria Dolores Reyes-Jara

  3. Departamento de Microbiologia, Hospital Marina Baixa, Villajoyosa, Alicante, Spain

    Carmen Martinez-Peinado, Barbara Gomez-Alonso & Francisco Arjona-Zaragozi

Authors
  1. Javier Ena
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  2. Raisa Goretti Afonso-Carrillo
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  3. Miriam Bou-Collado
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  4. Maria Dolores Reyes-Jara
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  5. Roser Navarro-Soler
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  6. David de Haedo-Sanchez
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  7. Carmen Martinez-Peinado
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  8. Barbara Gomez-Alonso
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  9. Francisco Arjona-Zaragozi
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Correspondence to Javier Ena.

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Statement of Human and animal right

The study was approved by the Research Commission of our center.

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As it was a retrospective study, the informed consent of the patients was not requested. The treatment of personal data was governed by organic law 15/1999 and Royal Decree 1720/2007 for its protection.

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Ena, J., Afonso-Carrillo, R.G., Bou-Collado, M. et al. Evaluation of FilmArray ME panel for the rapid diagnosis of meningitis–encephalitis in emergency departments. Intern Emerg Med 16, 1289–1295 (2021). https://doi.org/10.1007/s11739-020-02593-9

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  • DOI: https://doi.org/10.1007/s11739-020-02593-9

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