Laboratoire de Microbiologie, IHU Méditerranée Infection, Marseille, France.
Aix-Marseille Univ, IRD, MEPHI, IHU Méditerranée Infection, 19-21 bd Jean Moulin, 13385, Marseille CEDEX 05, France.
Eur J Clin Microbiol Infect Dis. 2020 Aug;39(8):1573-1580. doi: 10.1007/s10096-020-03859-y. Epub 2020 May 1.
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.
感染性脑膜炎是一种医学急症，必须快速检测病原体进入脑脊液（CSF），以指导患者的治疗。我们比较了多重聚合酶链反应 FilmArray® ME 检测板与标准微生物分析在快速诊断感染性脑膜炎中的性能。我们前瞻性地分析了常规实验室中所有用于诊断感染性脑膜炎的 CSF 样本，使用 FilmArray® ME 检测板平行检测 14 个目标，同时进行标准实时聚合酶链反应检测和细菌培养。我们回顾了获得不一致结果的患者的临床和生物学记录，以明确诊断。在 43 周的时间内，对 1124 例 CSF 样本进行了检测，FilmArray® ME 检测板和标准技术的阳性率分别为 113（10.1%）和 87（7.74%）。在 40 例产生不一致结果的 CSF 样本中，只有 34 例仅使用 FilmArray® ME 检测板阳性，6 例仅使用标准技术阳性。在总共 16/34（47.1%）FilmArray® ME 检测板阳性的 CSF 和 6/6（100%）标准技术阳性的 CSF 中，均被判断为真正的阳性。我们能够估计 FilmArray® ME 检测板的灵敏度、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 检测板是一种在床边快速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，其更高的灵敏度可提高真正阳性的诊断率。
