Pediatr Infect Vaccine.  2021 Aug;28(2):92-100. 10.14776/piv.2021.28.e9.

Diagnostic Evaluation of the BioFire ® Meningitis/Encephalitis Panel: A Pilot Study Including Febrile Infants Younger than 90 Days

Affiliations
  • 1Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, the Republic of Korea
  • 2Department of Pediatrics, Chung-Ang University Hospital, Seoul, the Republic of Korea
  • 3Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, the Republic of Korea
  • 4Department of Pediatrics, Seoul National University Children's Hospital, Seoul, the Republic of Korea
  • 5Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, the Republic of Korea
  • 6Department of Pediatrics, Seoul National University College of Medicine, Seoul, the Republic of Korea

Abstract

Purpose
Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants.
Methods
CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at −70°C until further use.
Results
In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire® ME panel testing.
Conclusions
Compared with the currently available etiologic tests for CNS infection, BioFire® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire® ME panel testing in children must be evaluated for its wider application.

Keyword

Enterovirus; Parechovirus; Meningitis; Multiplex polymerase chain reaction
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