Evaluation of the Utilization of FilmArray Meningitis/Encephalitis in Children With Suspected Central Nervous System Infection A Retrospective Case Series
Evaluation of the Utilization of FilmArray Meningitis/Encephalitis in Children With Suspected Central Nervous System Infection A Retrospective Case Series
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DOI：
10.1097/pec.0000000000002462
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发表时间：
2022-02-01
影响因子：
1.4
通讯作者：
Senne Soares, Carlos Augusto
中科院分区：
文献类型：
--
作者：
Domingues, Renan Barros;Mendes-Correa, Maria Cassia;Senne Soares, Carlos Augusto
中枢神经系统感染的病因学通常难以确定。脑炎脑膜炎多重病原体核酸联检试剂盒（脑炎脑膜炎多重病原体核酸联检试剂盒）是一种多重聚合酶链反应，可快速鉴定14种病原体。本研究的目的是评价在儿科人群中使用该方法的潜在现实贡献。方法我们在此报告了使用FilmArray ME对367例疑似中枢神经系统感染儿童进行回顾性病例系列检测的结果。我们通过FilmArray鉴定了病毒和细菌病原体，并在考虑脑脊液（CSF）分析的细胞学、生化和微生物结果的情况下评价了使用该试剂盒的潜在诊断贡献。结果脑炎脑膜炎多重病原体核酸联检试剂盒检出186例（50.7%）病毒感染和12例（3.3%）细菌感染。53例病毒感染病例（28.4%）至少有1项CSF检查结果可能被误认为细菌性脑膜炎。2例脑脊液检查结果正常的病例中检出肠道病毒。在12例细菌感染病例中，只有6例（50%）常规微生物学分析（革兰氏染色和培养）结果呈阳性。所有6例病例的CSF检查结果均提示细菌性脑膜炎，其中脑炎脑膜炎病毒阵列是鉴定细菌病原体的唯一方法。结论FilmArray ME试剂盒在常规CSF分析失败的病例中鉴定出病原体，为此类病例的管理提供了潜在的临床贡献。
Background The etiology of central nervous system infections is often difficult to establish. FilmArray meningitis/encephalitis (ME) panel is a multiplex polymerase chain reaction for rapid identification of 14 pathogens. The aim of this study was to evaluate potential real-life contributions of the use of this method in the pediatric population. Methods We herein report the results obtained with FilmArray ME in a retrospective case series of 367 children with suspected central nervous system infection. We identified viral and bacterial agents by FilmArray, and we evaluated the potential diagnostic contributions of the use of the panel taking into account the cytological, biochemical, and microbiological results of the cerebrospinal fluid (CSF) analysis. Results The FilmArray ME panel detected a viral infection in 186 cases (50.7%) and a bacterial infection in 12 cases (3.3%). Fifty-three cases (28.4%) of viral infection had at least 1 CSF finding that could be mistaken for bacterial meningitis. Enterovirus was identified in 2 cases with normal CSF findings. Among 12 bacterial infection cases, only 6 (50%) had a positive result with conventional microbiology analysis (Gram stain and culture). The CSF findings suggestive of bacterial meningitis were found in all 6 cases in which FilmArray was the only method to identify bacterial etiological agent. Conclusions FilmArray ME panel identified an etiological agent in cases in which conventional CSF analysis failed, providing potential clinical contributions to the management of such cases.