Neurological Sciences

, Volume 40, Issue 1, pp 81–88 | Cite as

FilmArray® meningitis/encephalitis (ME) panel, a rapid molecular platform for diagnosis of CNS infections in a tertiary care hospital in North India: one-and-half-year review

  • Bansidhar TaraiEmail author
  • Poonam Das
Original Article



Acute meningitis and encephalitis (AME) is a syndrome of central nervous system (CNS) infections, which could lead to neurological damage and fatality. This study evaluates the multiplex FilmArray® ME Panel which is aimed to diagnose agents causing suspect CNS infections in north India.


A total number of 969 cerebrospinal fluid (CSF) samples collected between August 2016 and January 2018 from patients who showed clinical symptoms of CNS infections were analyzed using the FilmArray® ME Panel. Also a comparison of molecular diagnosis and various laboratory and radiological findings for Streptococcus pneumoniae, Enterovirus and Cryptococcus neoformans positive cases was done.


Out of the 969 CSF samples, 101 cases were found to be positive for viral (n = 55), bacterial (n = 38), fungal (n = 7), and poly-microbial (n = 1) agents. Out of the 55 viral positive cases, the most detected pathogen was Enterovirus (n = 23) with predominance in the age group of 2–17 years, followed by Varicella Zoster virus (n = 14) and HSV1(n = 9) cases. Streptococcus pneumoniae (n = 26) was found to be the predominant bacterial pathogen, of which 17 were detected in the age group above 35 years. Cryptococcus neoformans was found in 7 cases.


The FilmArray® ME Panel aids in rapid detection of 14 pathogens directly from CSF. When compared to gram stain, culture, antigen detection, and CSF biochemical analysis, the FilmArray® ME Panel has detected more cases, some of which are difficult to diagnose by conventional methods. This rapid technology will help the clinicians in case of early patient management, outcomes and provide aid in antimicrobial stewardship.


Meningitis Encephalitis FilmArray Streptococcus pneumonia Enterovirus 



The authors thankfully acknowledge Alex van Belkum, Global Director of R&D Microbiology, bioMerieux and Richard Gonzalez, Medical Advisor – ASPAC, bioMerieux, for his helpful comments during the preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval from institute



  1. 1.
    Edmond K, Clark A, Korczak VS, Sanderson C, Griffiths UK, Rudan I (2010) Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis 10:317–328. CrossRefPubMedGoogle Scholar
  2. 2.
    Thigpen MC, Whitney CG, Messonnier NE, Zell ER, Lynfield R, Hadler JL, Harrison LH, Farley MM, Reingold A, Bennett NM, Craig AS, Schaffner W, Thomas A, Lewis MM, Scallan E, Schuchat A (2011) Bacterial meningitis in the United States, 1998–2007. N Engl J Med 364:2016–2025. CrossRefPubMedGoogle Scholar
  3. 3.
    Tack DM, Holman RC, Folkema AM, Mehal JM, Blanton JD, Sejvar JJ (2014) Trends in encephalitis-associated deaths in the United States, 1999–2008. Neuroepidemiology 43:1–8. CrossRefPubMedGoogle Scholar
  4. 4.
    Oostenbrink R, Moons KG, Theunissen CC, Derksen-Lubsen G, Grob-bee DE, Moll HA (2001) Signs of meningeal irritation at the emergency department: how often bacterial meningitis? Pediatr Emerg Care 17:161–164. CrossRefPubMedGoogle Scholar
  5. 5.
    van de Beek D, de Gans J, Spanjaard L, Weisfelt M, Reitsma JB, Vermeulen M (2004) Clinical features and prognostic factors in adults with bacterial meningitis. N Engl J Med 351:1849–1859. CrossRefPubMedGoogle Scholar
  6. 6.
    Bohr V, Rasmussen N, Hansen B, Kjersem H, Jessen O, Johnsen N, Kristensen HS (1983) 875 cases of bacterial meningitis: diagnostic procedures and the impact of preadmission antibiotic therapy. Part III of a three-part series. J Inf Secur 7:193–202Google Scholar
  7. 7.
    Nigrovic LE, Malley R, Macias CG, Kanegaye JT, Moro-Sutherland DM, Schremmer RD, Schwab SH, Agrawal D, Mansour KM, Bennett JE, Katsogridakis YL, Mohseni MM, Bulloch B, Steele DW, Kaplan RL, Herman MI, Bandyopadhyay S, Dayan P, Truong UT, Wang VJ, Bonsu BK, Chapman JL, Kuppermann N (2008) Effect of antibiotic retreatment on cerebrospinal fluid profiles of children with bacterial meningitis. Pediatrics 122:726–730. CrossRefPubMedGoogle Scholar
  8. 8.
    Gutierrez M, Emmanuel PJ (2018) Expanding molecular diagnostics for central nervous system infections. Adv Pediatr Infect Dis 65(1):209–227Google Scholar
  9. 9.
    Ramanan P, Bryson AL, Binnicker MJ, Pritt BS, Patel R (2017) Syndromic panel-based testing in clinical microbiology. Clin Microbiol Rev 31(1)Google Scholar
  10. 10.
    Fitch MT, van de Beek D (2007) Emergency diagnosis and treatment of adult meningitis. Lancet Infect Dis 7:191–200. CrossRefPubMedGoogle Scholar
  11. 11.
    Durand ML, Calderwood SB, Weber DJ, Miller SI, Southwick FS, Caviness VS Jr, Swartz MN (1993) Acute bacterial meningitis in adults. A review of 493 episodes. N Engl J Med 328:21–28CrossRefGoogle Scholar
  12. 12.
    Dash AP, Bhatia R, Sunyoto T, Mourya DT (2013) Emerging and re-emerging arboviral diseases in Southeast Asia. J Vector Borne Dis 50:77–84PubMedGoogle Scholar
  13. 13.
    WHO (2012) Establishing surveillance for acute meningitis and encephalitis syndromes through expansion of poliomyelitis and measles surveillance networks in Bangladesh, China and India, 2006–2008. Wkly Epidemiol Rec 87:513–519Google Scholar
  14. 14.
    Directorate of National Vector Borne Diseases Control Programme. Guidelines for surveillance of acute encephalitis syndrome (with special reference to Japanese encephalitis). Available at:
  15. 15.
    World Health Organization (2008) WHO recommended standards for surveillance of selected vaccine-preventable diseases. The Organization, GenevaGoogle Scholar
  16. 16.
    NVBDCP. Details of AES/JE Cases and Deaths from 2008–2014. Available at:
  17. 17.
    Leber AL, Everhart K, Balada-Llasat J-M, Cullison J, Daly J, Holt S et al (2016) Multicenter evaluation of BioFire FilmArray meningitis/encephalitis panel for detection of bacteria, viruses, and yeast in cerebrospinal fluid specimens. J Clin Microbiol 54(9):2251–2261CrossRefGoogle Scholar
  18. 18.
    Naccache SN, Lustestica M, Fahit M, Mestas J, Dien BJ (2018) One year in the life of a rapid syndromic panel for meningitis/encephalitis: a pediatric tertiary care facility’s experience. J Clin Microbiol 56(5)Google Scholar
  19. 19.
    Marchioni E, Ravaglia S, Piccolo G, Furione M, Zardini E, Franciotta D, Alfonsi E, Minoli L, Romani A, Todeschini A, Uggetti C, Tavazzi E, Ceroni M (2005) Postinfectious inflammatory disorders: subgroups based on prospective follow-up. Neurology 65(7):1057–1065CrossRefGoogle Scholar
  20. 20.
    Marchioni E, Ravaglia S, Montomoli C, Tavazzi E, Minoli L, Baldanti F, Furione M, Alfonsi E, Bergamaschi R, Romani A, Piccolo L, Zardini E, Bastianello S, Pichiecchio A, Ferrante P, Delbue S, Franciotta D, Bono G, Ceroni M (2013) Postinfectious neurologic syndromes: a prospective cohort study. Neurology 80(10):882–889CrossRefGoogle Scholar
  21. 21.
    Mastrangelo F et al (2018) J Biol Regul Homeost Agents 32(2):195–198 Low-grade chronic inflammation mediated by mast cells in fibromyalgia: role of IL-37PubMedGoogle Scholar
  22. 22.
    Brouwer MC, Tunkel AR, van de Beek D (2010) Epidemiology, diagnosis, and antimicrobial treatment of acute bacterial meningitis. Clin Microbiol Rev 23:467–492. CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Hussein AS, Shafran SD (2000) Acute bacterial meningitis in adults. A 12-year review. Medicine (Baltimore) 79:360–368CrossRefGoogle Scholar
  24. 24.
    Tajiri T, Tate G, Enosawa T, Acita H, Ohine N, Masunaga A et al (2007) Clinicopathological findings in fulminant-type pneumococcal infection: report of three autopsy cases. Pathol Int 57:606–612CrossRefGoogle Scholar
  25. 25.
    Newland A, Provan D, Myint S (2005) Preventing severe infection after splenectomy. BMJ 331:417–418CrossRefGoogle Scholar
  26. 26.
    Kupila L, Vuorinen T, Vainionpää R, Hukkanen V, Marttila RJ, Kotilainen P (2006) Aetiology of aseptic meningitis and encephalitis in an adult population. Neurology 66:75–80CrossRefGoogle Scholar
  27. 27.
    Bhatt GC, Sharma T Clinical profile and outcome of Japanese encephalitis in children admitted with acute encephalitis syndromeGoogle Scholar
  28. 28.
    Suri V, Narang U, Bhalla A Viral encephalitis in India: management UpdateGoogle Scholar
  29. 29.
    Wu-Chung Shen, Hsiu-Hui Chiu, Kuan-Chih Chow, and Chang-Hai Tsai, MR imaging findings of enteroviral encephalomyelitis: an outbreak in TaiwanGoogle Scholar
  30. 30.
    Goren A, Mccoy J, Kovacevic M, Situm M, Lonky N (2017) Potential risk of developing herpes simplex encephalitis in patients treated with sildenafil following primary exposure to genital herpes. J Biol Regul Homeost Agents 31(3):679–682PubMedGoogle Scholar
  31. 31.
    Zunt JR (2002) Central nervous system infection during immunosuppression. Neurol Clin 20:1–22. CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Debiasi RL, Tyler KL (2004) Molecular methods for diagnosis of viral encephalitis. Clin Microbiol Rev 17:903–925. CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    BioFire Diagnostics (2015) FilmArray meningitis/encephalitis (ME) panel instruction booklet RF-Y-ASY-0118. BioFire Diagnostics, Salt Lake CityGoogle Scholar
  34. 34.
    Parida M, Dash PK, Tripathi NK, Ambuj, Sannarangaiah S, Saxena P et al (2006) Japanese encephalitis outbreak, India, 2005. Emerg Infect Dis 12:1427–1430CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of Lab MedicineMax Superspeciality HospitalNew DelhiIndia

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