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Point-of-care multiplexed diagnosis of meningitis using the FilmArray® ME panel technology.
European Journal of Clinical Microbiology & Infectious Diseases ( IF 3.7 ) Pub Date : 2020-05-01 , DOI: 10.1007/s10096-020-03859-y
Jean-Jacques Vincent 1 , Christine Zandotti 1 , Sophie Baron 1, 2 , Christian Kandil 1 , Pierre-Yves Levy 1, 3 , Michel Drancourt 1, 2 , Didier Raoult 1, 2 , Laetitia Ninove 1, 4
Affiliation  

Infectious meningitis is a medical urgency and rapid detection of the causative pathogen into the cerebrospinal fluid (CSF) is mandatory to guide the management of patients. We compared the performances of the multiplexed PCR FilmArray® ME panel with standard microbiological analyses, for rapid diagnosis of infectious meningitis. All the CSF samples received in our routine laboratory for the diagnosis of infectious meningitis were prospectively analyzed by the FilmArray® ME panel for the detection of fourteen targets in parallel to standard routine real-time PCR assays and bacterial culture. We reviewed clinical and biological records of patients for whom a discrepant result was obtained to achieve a definite diagnosis. Among 1124 CSF samples tested over a 43-week period, 113 (10.1%) and 87 (7.74%) were positive using the FilmArray® ME panel and the standard techniques, respectively. Among 40 CSF samples which yielded discrepant results, 34 were positive only using the FilmArray® ME panel and 6 were positive only using standard techniques. A total of 16/34 (47.1%) FilmArray® ME panel−positive CSF, and 6/6 (100%) of standard technique−positive CSF were interpreted as true positive. We were able to estimate the sensitivity, the specificity, the positive predictive value, and the negative predictive value of the FilmArray® ME panel at 94.2%, 98.2%, 84.3%, and 99.4%, respectively. The FilmArray® ME panel is an efficient tool for the rapid diagnosis of infectious meningitis at the point-of-care. Its higher sensitivity compared with that of standard molecular biology and culture techniques yields an increase of true positive diagnosis.



中文翻译:

使用FilmArray®ME面板技术进行即时护理的脑膜炎多重诊断。

传染性脑膜炎是一种医学急症,必须迅速将病原性病原体检测到脑脊液(CSF)中,以指导患者的治疗。我们将多重PCRFilmArray®ME板与标准微生物学分析的性能进行了比较,以快速诊断传染性脑膜炎。通过FilmArray®ME小组对我们常规实验室中用于诊断传染性脑膜炎的所有CSF样品进行了前瞻性分析,与标准的常规实时PCR分析和细菌培养平行地检测了14个靶标。我们回顾了获得明确结果的患者的临床和生物学记录。在43周内测试的1124个CSF样本中,有113个(10.1%)和87个(7。使用FilmArray®ME面板和标准技术分别为74%阳性。在40个产生差异结果的CSF样品中,只有34个使用FilmArray®ME面板为阳性,而6个仅使用标准技术为阳性。总共16/34(47.1%)FilmArray®ME面板阳性CSF和标准技术阳性CSF的6/6(100%)被解释为真正阳性。我们能够估计FilmArray®ME面板的灵敏度,特异性,阳性预测值和阴性预测值分别为94.2%,98.2%,84.3%和99.4%。FilmArray®ME面板是在现场即时诊断感染性脑膜炎的有效工具。与标准分子生物学和培养技术相比,它具有更高的灵敏度,可以增加真正的阳性诊断。

更新日期:2020-05-01
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