D Nestor1, S Thulin Hedberg2, M Lignell3, S Skovbjerg4, P Mölling5, M Sundqvist6. 1. Department of Laboratory Medicine, Clinical Microbiology, University Hospital, Örebro SE-701 85, Sweden. Electronic address: david.nestor@regionorebrolan.se. 2. Department of Laboratory Medicine, Clinical Microbiology, University Hospital, Örebro SE-701 85, Sweden; Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro SE-701 82, Sweden. Electronic address: sara.thulin-hedberg@regionorebrolan.se. 3. Department of Bacteriology, Clinical Microbiological Laboratory, Sahlgrenska University Hospital, PO Box 435, SE-405 30 Gothenburg, Sweden. Electronic address: marie.lignell@vgregion.se. 4. Department of Bacteriology, Clinical Microbiological Laboratory, Sahlgrenska University Hospital, PO Box 435, SE-405 30 Gothenburg, Sweden; Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, PO Box 480, SE-405 30 Gothenburg, Sweden. Electronic address: susann.skovbjerg@vgregion.se. 5. Department of Laboratory Medicine, Clinical Microbiology, University Hospital, Örebro SE-701 85, Sweden; Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro SE-701 82, Sweden. Electronic address: paula.molling@regionorebrolan.se. 6. Department of Laboratory Medicine, Clinical Microbiology, University Hospital, Örebro SE-701 85, Sweden; Department of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro SE-701 82, Sweden. Electronic address: martin.sundqvist@regionorebrolan.se.
Abstract
PURPOSE: Molecular methods provide fast and accurate detection of both bacteria and viruses in the cerebrospinal fluid (CSF) causing infection in the central nervous system (CNS). In the present study we evaluated the bacterial detection performance of the fully automated FilmArray™ Meningitis/Encephalitis (ME) panel (bioMérieux) by comparing it with culture and multiplexed in-house PCR. METHODS: Three sample types were analysed; Contrived samples with known bacterial/fungal concentration (n = 29), clinical samples from patients with verified cause of CNS infection (n = 17) and external quality assessment (EQA) samples (n = 11). Another six samples were purposely prepared with multiple targets to evaluate multiplex capacity. RESULTS: The FilmArray™ had a slightly higher limit of detection for Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes and Streptococcus agalactiae compared to in-house PCR methods but performed equal or better when compared to culture. The FilmArray™ ME panel detected the expected pathogen in 17 of 17 clinical samples and yielded detection of three additional viruses of which one was confirmed with comparator techniques. All but one of the EQA samples were correctly detected. CONCLUSIONS: The results of this study are promising and the FilmArray™ ME panel could add to the diagnostic algorithm in CNS-infections. However, the limit of detection for the important pathogens N. meningitidis and S. pneumoniae could be improved.
PURPOSE: Molecular methods provide fast and accurate detection of both bacteria and viruses in the cerebrospinal fluid (CSF) causing infection in the central nervous system (CNS). In the present study we evaluated the bacterial detection performance of the fully automated FilmArray™ Meningitis/Encephalitis (ME) panel (bioMérieux) by comparing it with culture and multiplexed in-house PCR. METHODS: Three sample types were analysed; Contrived samples with known bacterial/fungal concentration (n = 29), clinical samples from patients with verified cause of CNS infection (n = 17) and external quality assessment (EQA) samples (n = 11). Another six samples were purposely prepared with multiple targets to evaluate multiplex capacity. RESULTS: The FilmArray™ had a slightly higher limit of detection for Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes and Streptococcus agalactiae compared to in-house PCR methods but performed equal or better when compared to culture. The FilmArray™ ME panel detected the expected pathogen in 17 of 17 clinical samples and yielded detection of three additional viruses of which one was confirmed with comparator techniques. All but one of the EQA samples were correctly detected. CONCLUSIONS: The results of this study are promising and the FilmArray™ ME panel could add to the diagnostic algorithm in CNS-infections. However, the limit of detection for the important pathogens N. meningitidis and S. pneumoniae could be improved.