Chandran Sarath, Arjun Rajalakshmi, Sasidharan Aswathy, Niyas Vettakkara Km, Chandran Suresh
Department of Internal Medicine, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India.
Department of Infectious Diseases, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India.
Indian J Crit Care Med. 2022 Jan;26(1):67-70. doi: 10.5005/jp-journals-10071-24078.
Early identification of etiology is very important for initiating appropriate therapy promptly in patients with meningoencephalitis (ME). BioFire FilmArray meningitis/encephalitis (FA-ME) panel is a fully automated multiplex polymerase chain reaction (PCR) that detects 14 pathogens simultaneously in an hour. There is a dearth of studies highlighting its usefulness in ME syndrome in Indian patients.
We performed a retrospective analysis of patients, admitted to the Kerala Institute of Medical Sciences Hospital, Thiruvananthapuram, Kerala, South India, with meningitis/encephalitis syndrome who underwent the multiplex PCR test on cerebrospinal fluid (CSF) over a period of 2 years from 2016 to 2018. Patients presenting with clinical diagnosis of acute meningitis, encephalitis, or ME who underwent CSF FA-ME panel were studied. The performance of the FA-ME panel was compared to CSF bacterial culture.
Two-hundred and fifty-nine patients between December 2016 and December 2018 underwent the FA-ME test in CSF. FA-ME test detected pathogens in 61 (23.6%) out of 259 patients with ME syndrome. Among the pathogens detected by FA-ME panel, enterovirus was the commonest accounting for 29 cases (47.5%), followed by varicella in 11 patients (18%) and pneumococci in 9 (14.8%). CSF bacterial culture yield was low, positive only in 8 (3%) out of 259 cases, and matched with FA-ME panel in only one sample that grew . Bacterial culture yielded seven pathogens in those whose FA-ME panels were negative.
FA-ME panel improves diagnostic yield as compared to bacterial culture (26.3 vs 3%). FA-ME test helps in the early initiation of targeted antibiotic therapy and greater antibiotic de-escalation.
Chandran S, Arjun R, Sasidharan A, Niyas VKM, Chandran S. Clinical Performance of FilmArray Meningitis/Encephalitis Multiplex Polymerase Chain Reaction Panel in Central Nervous System Infections. Indian J Crit Care Med 2022;26(1):67-70.
对于脑膜脑炎（ME）患者，尽早确定病因对于及时启动恰当治疗非常重要。BioFire FilmArray 脑膜炎/脑炎（FA-ME）检测板是一种全自动多重聚合酶链反应（PCR）检测方法，可在一小时内同时检测 14 种病原体。目前缺乏强调其在印度患者 ME 综合征中作用的研究。
我们对 2016 年至 2018 年期间在印度南部喀拉拉邦特里凡得琅市喀拉拉医学科学研究所医院收治的患有脑膜炎/脑炎综合征且接受了脑脊液（CSF）多重 PCR 检测的患者进行了回顾性分析。对临床诊断为急性脑膜炎、脑炎或 ME 且接受了 CSF FA-ME 检测板检测的患者进行研究。将 FA-ME 检测板的性能与 CSF 细菌培养进行比较。
2016 年 12 月至 2018 年 12 月期间，259 例患者接受了 CSF 的 FA-ME 检测。FA-ME 检测在 259 例 ME 综合征患者中的 61 例（23.6%）中检测到病原体。在 FA-ME 检测板检测到的病原体中，肠道病毒最为常见，占 29 例（47.5%），其次是水痘病毒 11 例（18%），肺炎球菌 9 例（14.8%）。CSF 细菌培养阳性率低，259 例中仅 8 例（3%）呈阳性，且仅在一个培养生长的样本中与 FA-ME 检测板结果相符。在 FA-ME 检测板为阴性的患者中，细菌培养检出了 7 种病原体。
与细菌培养相比，FA-ME 检测板提高了诊断阳性率（26.3%对 3%）。FA-ME 检测有助于尽早启动针对性抗生素治疗并更大程度地降低抗生素使用级别。
Chandran S, Arjun R, Sasidharan A, Niyas VKM, Chandran S. FilmArray 脑膜炎/脑炎多重聚合酶链反应检测板在中枢神经系统感染中的临床性能。《印度重症监护医学杂志》2022；26(1):67 - 70。
