2026-04-17T14:57:47Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/2205822025-12-05T05:45:52Zcom_2072_1057col_2072_478824col_2072_478858col_2072_478917

Multiplex real-time PCR FilmArray performance in the diagnosis of meningoencephalitis: lights and shadows López, Néstor Cuesta Chasco, Genoveva Rodríguez Vega, Sara Rosas, Enric Chumbita, Mariana Casals Pascual, Climent Morata, Laura Vergara, Andrea Bodro, Marta Bosch, Jordi Herrera, Sabina Martínez, José Antonio Mensa Pueyo, Josep Garcia Vidal, Carolina Marcos, Ma. Angeles Vila Estapé, Jordi Soriano Viladomiu, Alex Puerta-Alcalde, Pedro Diagnòstic Infeccions Encefalitis Reacció en cadena de la polimerasa Meningitis Diagnosis Infections Encephalitis Polymerase chain reaction Meningitis Purpose: We aimed to evaluate the performance of the FilmArray (FA) meningitis/encephalitis (ME) panel. Secondarily, we analyzed the false positive (FP) and false negative (FN) results, as well as the predictive values of the technique, regarding the cerebrospinal fluid (CSF) characteristics. Methods: FA is a multiplex real-time PCR detecting 14 of the most common ME pathogens in CSF. All FA performed at our hospital (2018-2022) were retrospectively reviewed. FA was compared to conventional techniques and its performance was assessed based on the final diagnosis of the episode. Results: FA was performed in 313 patients with suspicion of ME. Most patients had altered mental status (65.2%) and fever (61%). Regarding CSF characteristics, 49.8% and 53.7% presented high CSF proteins and pleocytosis, respectively. There were 84 (26.8%) positive FA results, mainly for HSV-1 (10.9%), VZV (5.1%), Enterovirus (2.6%), and S. pneumoniae (1.9%). In the 136 cases where both FA and routine methods were performed, there was a 25.7% lack of agreement. We identified 6.6% FN results, but 28.6% FP, mainly due to HSV-1. This resulted in a high negative predictive value (NPV) of 93.4%, but a positive predictive value (PPV) of 73%. Remarkably, PPV as low as 36.9%, and 70.2%, were found in cases without pleocytosis, or lack of high CSF protein levels, respectively. Conclusion: FA was associated with high NPV, but frequent FP results and low PPV, particularly for HSV-1, and especially in patients without high CSF protein levels or pleocytosis. 2025-04-24T15:06:18Z 2025-04-24T15:06:18Z 2023-07-29 2025-04-24T15:06:18Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 0300-8126 https://hdl.handle.net/2445/220582 741679 37515691 eng Reproducció del document publicat a: https://doi.org/10.1007/s15010-023-02076-x Infection, 2023, vol. 52, num.1, p. 165-172 https://doi.org/10.1007/s15010-023-02076-x cc-by (c) López, Néstor et al., 2023 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess 8 p. application/pdf Springer Verlag Articles publicats en revistes (Fonaments Clínics)