Rapid Diagnostic Testing Analyzed in Suspected Meningitis Diagnosis

The scientists gathered data from annual chart reviews over a 3-year period before and after implementation of the ME multiplex PCR panel on February 14, 2017. There were 137 patients in the pre-panel period and 69 patients in the post-panel period.

The investigators reported that the positive detection rate of bacterial pathogens was 3/137 (2.2%) by CSF culture in the pre-multiplex PCR ME panel period and 3/69 (4.3%) by the multiplex PCR ME panel in the post-multiplex PCR ME panel period. There was no difference in the proportion of patients for whom any pathogen was detected by microbiological testing between pre- and post-multiplex PCR ME panel periods (17.5% versus 20.3%). They found that once the panel was implemented, 46% more patients had empiric antibiotic therapy discontinued or de-escalated compared with before the panel was used.

Among 14 patients in the post-multiplex PCR ME panel period for whom a pathogen was identified, three patients had therapy targeted to bacterial pathogens (two S. pneumoniae, one H. influenzae) and 11 to viral pathogens (five enterovirus, three herpes simplex virus 2, three varicella zoster virus). The average turnaround time for the multiplex PCR ME panel was 2.6 hours. In the pre-multiplex PCR ME panel period, the average turnaround time for viral pathogen testing (performed by a viral encephalitis PCR panel on CSF samples) was 71.3 hours.

The authors concluded that implementation of a multiplex PCR ME panel for testing of adult patients who present to the emergency department with suspected bacterial meningitis appears to reduce the duration of empiric antibiotic therapy, time to targeted therapy, and possibly hospital length of stay compared with traditional microbiological testing methods. The study was published in the October, 2021 issue of the journal Open Forum Infectious Diseases.

Related Links:
Weill Cornell Medicine
BioFire Diagnostics