<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
<article xlink="http://www.w3.org/1999/xlink" dtd-version="1.0"><Article><Journal><PublisherName>jneuro</PublisherName><JournalTitle>Journal of Neurology and Neuropsychiatry</JournalTitle><PISSN>c</PISSN><EISSN>o</EISSN><Volume-Issue>Volume 2 Issue 2 (July-Dec)</Volume-Issue><IssueTopic>Multidisciplinary</IssueTopic><IssueLanguage>English</IssueLanguage><Season>6 Months </Season><SpecialIssue>N</SpecialIssue><SupplementaryIssue>N</SupplementaryIssue><IssueOA>Y</IssueOA><PubDate><Year>2025</Year><Month>12</Month><Day>30</Day></PubDate><ArticleType>Neuropsychiatry</ArticleType><ArticleTitle>Diagnostic Accuracy of Meningitis/Encephalitis (ME) Panel for Central Nervous System Infections: An Updated Meta-Analysis</ArticleTitle><SubTitle/><ArticleLanguage>English</ArticleLanguage><ArticleOA>Y</ArticleOA><FirstPage>24</FirstPage><LastPage>38</LastPage><AuthorList><Author><FirstName>Ralph Louie</FirstName><LastName>Bautista</LastName><AuthorLanguage>English</AuthorLanguage><Affiliation/><CorrespondingAuthor>N</CorrespondingAuthor><ORCID/></Author></AuthorList><DOI/><Abstract>Central nervous system infections (CNSI) are severe, life-threatening conditions that require rapid and accurate diagnosis for effective management. To address diagnostic challenges in CNSI, molecular diagnostic tools have been developed to improve the detection and identification of CNS pathogens.Objectives: This study aims to assess the diagnostic accuracy of the BioFire® FilmArray® Meningitis/Encephalitis (ME) Panel in detecting CNS pathogens and compare its performance with cerebrospinal fluid (CSF) culture and single-target polymerase chain reaction (PCR).Methods: A systematic literature search identified studies published between 2016 and 2024. Data were analyzed and evaluated the Cochrane RevMan Web.Results: Twenty-three studies were included with a total of 11,182 patients. The ME Panel exhibited high accuracy for viral pathogens, with an average sensitivity of 97% and specificity of 99.8%, particularly for Enterovirus, Herpes Simplex Virus (HSV), and Varicella Zoster Virus (VZV). Bacterial detection showed greater variability, with a pooled sensitivity of 89% and specificity of 99.6%, highlighting challenges in detecting S. pneumoniae and L. monocytogenes. Sensitivity for Cryptococcus was lower at 70%, although specificity remained high at 99%.Conclusion: The ME Panel provides rapid and accurate detection of CNSI, facilitating timely treatment decisions. However, its cost and limited pathogen coverage may hinder its use in resource-limited settings.</Abstract><AbstractLanguage>English</AbstractLanguage><Keywords>CNS infections, meningitis, encephalitis, multiplex PCR, diagnostic accuracy, ME panel, FilmArray, meta-analysis</Keywords><URLs><Abstract>https://jneuro.clsconf.com/admin/abstract?id=31</Abstract></URLs><References><ReferencesarticleTitle>References</ReferencesarticleTitle><ReferencesfirstPage>16</ReferencesfirstPage><ReferenceslastPage>19</ReferenceslastPage><References>Wunrow HY, Benlder RG, Vongpradith A, Sirota SB, Swetschinski LR, Novotney A, Gray AP, Ikuta KS, Sharara F, Wool EE, Aali A. Global, regional, and national burden of meningitis and its aetiologies, 1990and;ndash;2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology. 2023;22(8):685and;ndash;711. https://doi.org/10.1016/S1474-4422(23)00195-3 [Google Scholar] [PubMed]Wang H, Zhao S, Wang S, et al. Global magnitude of encephalitis burden and its evolving pattern over the past 30 years. Journal of Infection. 2022;84(6):777and;ndash;787. https://doi.org/10.1016/j.jinf.2022.04.026 [Google Scholar] [PubMed]Zunt JR, Kassebaum NJ, Blake N, Glennie L, Wright C, Nichols E, Abd-Allah F, Abdela J, Abdelalim A, Adamu AA, Adib MG. Global, regional, and national burden of meningitis, 1990and;ndash;2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology. 2018;17(12):1061and;ndash;1082. https://doi.org/10.1016/S1474-4422(18)30387-9 [Google Scholar] [PubMed]Dumkow LE, Worden LJ, Rao SN. Syndromic diagnostic testing: a new way to approach patient care in the treatment of infectious diseases. Journal of Antimicrobial Chemotherapy. 2021;76(Suppl 3):iii2and;ndash;iii9. https://doi.org/10.1093/jac/dkab247 [Google Scholar] [PubMed]Radmard S, Reid S, Ciryam P, Boubour A, Ho N, Zucker J, Sayre D, Greendyke WG, Miko BA, Pereira MR, Whittier S. Clinical utilization of the FilmArray meningitis/encephalitis (ME) multiplex polymerase chain reaction (PCR) assay. Frontiers in Neurology. 2019;10:281. https://doi.org/10.3389/fneur.2019.00281 [Google Scholar] [PubMed]Hemmert A, DesJarlais S, McKinley K, Bourzac K, Holmberg K, Crisp R, Schreckenberger P. Comprehensive testing of CSF specimens using the FilmArray ME panel identifies viral infections overlooked using current clinical practices. Presented at ECCMID Conference, 2015. DOI: N/A [Google Scholar] [PubMed]Trujillo-Gand;oacute;mez J, Tsokani S, Arango-Ferreira C, Atehortand;uacute;a-Muand;ntilde;oz S, Jimenez-Villegas MJ, Serrano-Tabares C, Veroniki AA, Florez ID. Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: a systematic review and diagnostic test accuracy meta-analysis. EClinicalMedicine. 2022;44:101275. https://doi.org/10.1016/j.eclinm.2022.101275 [Google Scholar] [PubMed]Tansarli GS, Chapin KC. Diagnostic test accuracy of the BioFire FilmArray meningitis/encephalitis panel: a systematic review and meta-analysis. Clinical Microbiology and Infection. 2020;26(3):281and;ndash;290. https://doi.org/10.1016/j.cmi.2019.11.016 [Google Scholar] [PubMed]Ocampo FF, Laxamana LC. Diagnostic accuracy of the FilmArray Meningitis/Encephalitis panel in adult patients with suspected bacterial meningitis in a tertiary care hospital in the Philippines. Acta Medica Philippina. 2022;56(13). https://doi.org/10.47895/amp.v56i13.4485 [Google Scholar] [PubMed]Whiting P, Rutjes A, Marie W, Mallet S, Deeks J, Reitsma J, et al. QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies. Annals of Internal Medicine. 2011;155(8):529and;ndash;536. https://doi.org/10.7326/0003-4819-155-8-201110180-00009 [Google Scholar] [PubMed]Band;aring;rnes GK, Gudina EK, Berhane M, Abdissa A, Tesfaw G, Abebe G, et al. New molecular tools for meningitis diagnostics in Ethiopia - a necessary step towards improving antimicrobial prescription. BMC Infectious Diseases. 2018;18(1):684. https://doi.org/10.1186/s12879-018-3561-5 [Google Scholar] [PubMed]El-Nawawy AA, Antonios MA, Tawfik ME, Meheissen MA. Comparison of a point-of-care FilmArray test to standard-of-care microbiology test in diagnosis of healthcare-associated infections in a tertiary care pediatric intensive care unit. Antibiotics. 2022;11(4):487. https://doi.org/10.3390/antibiotics11040487 [Google Scholar] [PubMed]Obaro S, Hassan-Hanga F, Medugu N, Olaosebikan R, Olanipekun G, Jibir B, Gambo S, Ajose T, Duru C, Ebruke B, Davies HD. Comparison of bacterial culture with BioFire FilmArray multiplex PCR screening of archived cerebrospinal fluid specimens from children with suspected bacterial meningitis in Nigeria. BMC Infectious Diseases. 2023;23(1):68. https://doi.org/10.1186/s12879-023-07924-4 [Google Scholar] [PubMed]Debbagh F, Harrar S, Babokh F, Hanchi AL, Soraa N. The contribution of multiplex polymerase chain reaction in the diagnosis of central nervous system infections in intensive care units. Cureus. 2023;15(2):e35168. https://doi.org/10.7759/cureus.35168 [Google Scholar] [PubMed]Ellis J, Bangdiwala AS, Cresswell FV, Rhein J, Nuwagira E, Ssebambulidde K, Tugume L, Rajasingham R, Bridge SC, Muzoora C, Meya DB. The changing epidemiology of HIV-associated adult meningitis, Uganda 2015and;ndash;2017. Open Forum Infectious Diseases. 2019;6(10):ofz419. https://doi.org/10.1093/ofid/ofz419 [Google Scholar] [PubMed]Arora HS, Asmar BI, Salimnia H, Agarwal P, Chawla S, Abdel-Haq N. Enhanced identification of group B streptococcus and Escherichia coli in young infants with meningitis using the Biofire Filmarray Meningitis/Encephalitis panel. Pediatric Infectious Disease Journal. 2017;36(7):685and;ndash;687. https://doi.org/10.1097/INF.0000000000001528 [Google Scholar] [PubMed]Bailu D, Hua C, Xia Y, Li J, Xie Y, Tao Y, et al. Evaluation of the BioFire FilmArray meningitis/encephalitis panel for the detection of bacteria and yeast in Chinese children. Annals of Translational Medicine. 2019;7(18):437. https://doi.org/10.21037/atm.2019.08.64 [Google Scholar] [PubMed]Boudet A, Pantel A, Carles MJ, Bocland;eacute; H, Charachon S, Enault C, et al. A review of a 13-month period of FilmArray Meningitis/Encephalitis panel implementation as a first-line diagnosis tool at a university hospital. PLOS ONE. 2019;14(10):e0223887. https://doi.org/10.1371/journal.pone.0223887 [Google Scholar] [PubMed]Chong BSW, Kennedy KJ. Comparison of a commercial real-time PCR panel to routine laboratory methods for the diagnosis of meningitis-encephalitis. Pathology. 2021;53(5):644and;ndash;651. https://doi.org/10.1016/j.pathol.2021.03.006 [Google Scholar] [PubMed]Domingues RB, Santos MV, Leite FB, Senne C. FilmArray Meningitis/Encephalitis (ME) panel in the diagnosis of bacterial meningitis. Brazilian Journal of Infectious Diseases. 2019;23(6):405and;ndash;409. https://doi.org/10.1016/j.bjid.2019.10.003 [Google Scholar] [PubMed]Eichinger A, Hagen A, Meyer-Band;uuml;hn M, Huebner J. Clinical benefits of introducing real-time multiplex PCR for cerebrospinal fluid as routine diagnostic at a tertiary care pediatric center. Infection. 2019;47(1):51and;ndash;58. https://doi.org/10.1007/s15010-018-1216-5 [Google Scholar] [PubMed]Hanson KE, Slechta ES, Killpack JA, Heyrend C, Lunt T, Daly JA, et al. Preclinical assessment of a fully automated multiplex PCR panel. Journal of Clinical Microbiology. 2016;54(3):785and;ndash;787. https://doi.org/10.1128/JCM.02850-15 [Google Scholar] [PubMed]Hara M, Ishihara M, Nakajima H. Use of the FilmArray Meningitis/Encephalitis panel to detect pathogenic microorganisms in cerebrospinal fluid specimens: a single-center retrospective study. Journal of International Medical Research. 2022;50(10). https://doi.org/10.1177/03000605221129261 [Google Scholar] [PubMed]Leber AL, Everhart K, Balada-Llasat JM, Cullison J, Daly J, Holt S, et al. Multicenter evaluation of BioFire FilmArray Meningitis/Encephalitis Panel. Journal of Clinical Microbiology. 2016;54(9):2251and;ndash;2261. https://doi.org/10.1128/JCM.00730-16 [Google Scholar] [PubMed]Lee SH, Chen SY, Chien JY, Lee TF, Chen JM, Hsueh PR. Usefulness of the FilmArray meningitis/encephalitis panel for diagnosis in Taiwan. Journal of Microbiology, Immunology and Infection. 2019;52(5):760and;ndash;768. https://doi.org/10.1016/j.jmii.2018.01.004 [Google Scholar] [PubMed]Leli C, Gotta F, Vay D, Calcagno L, Callegari T, Cassinari M, et al. Diagnostic accuracy of a commercial multiplex PCR. Infezioni in Medicina. 2019;27(2):171and;ndash;179. DOI: N/A [Google Scholar] [PubMed]Lindstrand;ouml;m J, Elfving K, Lindh M, Westin J, Studahl M. Assessment of the FilmArray ME panel in 4199 cerebrospinal fluid samples. Clinical Microbiology and Infection. 2022;28(1):121.e1and;ndash;121.e6. https://doi.org/10.1016/j.cmi.2021.05.030 [Google Scholar] [PubMed]Messacar K, Breazeale G, Robinson CC, Dominguez SR. Potential clinical impact of the FilmArray meningitis/encephalitis panel in children. Diagnostic Microbiology and Infectious Disease. 2016;86(1):109and;ndash;111. https://doi.org/10.1016/j.diagmicrobio.2016.07.005 [Google Scholar] [PubMed]Piccirilli G, Chiereghin A, Gabrielli L, Giannella M, Squarzoni D, Turello G, et al. Infectious meningitis/encephalitis evaluation of multiplex PCR. New Microbiologica. 2018;41(2):103and;ndash;107. DOI: N/A [Google Scholar] [PubMed]Radmard S, Reid S, Ciryam P, Boubour A, Ho N, Zucker J, et al. Clinical utilization of the FilmArray meningitis/encephalitis assay. Frontiers in Neurology. 2019;10:281. https://doi.org/10.3389/fneur.2019.00281 [Google Scholar] [PubMed]Vincent JJ, Zandotti C, Baron S, Kandil C, Levy PY, Drancourt M, et al. Point-of-care multiplexed diagnosis of meningitis using the FilmArray ME panel technology. European Journal of Clinical Microbiology and;amp; Infectious Diseases. 2020;39(8):1573and;ndash;1580. https://doi.org/10.1007/s10096-020-03859-9 [Google Scholar] [PubMed]</References></References></Journal></Article></article>
