Use of FilmArray® in the diagnosis of bacterial meningitis

Introduction: The Meningitis/Encephalitis FilmArray is an automated multiplex polymerase chain reaction for identifying 14 central nervous system (CNS) care agents, including viruses, Cryptococcus, and bacteria. The following bacteria are tested: E. coli K1, H. influenzae, L. monocytogenes, N. meningitidis, S. agalactiae and pneumoniae. In this study we compared the performance of FilmArray® with conventional microbiological methods for bacterial meningitis. Methods: We retrospectively evaluated data from 903 patients with CNS infection manifested by the method. Results: 42 cases were positive for bacteria, E. coli K1=2, H. influenzae=7, L. monocytogenes=5, N. meningitidis=9, S. pneumoniae=20. Of these, only 14 (33.34%) were positive with conventional microbiological methods, including culture and/or bacterioscopy. Three patients were negative on FilmArray® and positive with other methods: 2 culture positive (S. intermedius and Micrococcus) and one Gram negative. All 28 cases positive only with FilmArray® adopted a cerebrospinal fluid infection pattern suggestive of bacterial meningitis: pleocytosis with neutrophilic predominance, increased protein and lactate, and hypoglycorrhachia. Conclusion: The study confirms previous data indicating that FilmArray® increases the sensitivity of etiological diagnosis of bacterial meningitis.