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Evaluating the Impact of the BioFire FilmArray in Childhood Meningitis: An Observational Cohort Study

Kadambari, Seilesh, Feng, Shuo, Liu, Xinxue, Andersson, Monique, Waterfield, Rebecca, Fodder, Harriet, Jacquemot, Aimee, Galal, Ushma, Rafferty, Aisling, Drew, Richard J., Rodrigues, Charlene, Sadarangani, Manish, Riordan, Andrew, Martin, Natalie G., Defres, Sylviane, Solomon, Tom, Pollard, Andrew J. and Paulus, Stephane (2024) 'Evaluating the Impact of the BioFire FilmArray in Childhood Meningitis: An Observational Cohort Study'. Pediatric Infectious Disease Journal, Vol 43, Issue 4, pp. 345-349.

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Abstract

Background
Multiplex polymerase chain reaction assays have the potential to reduce antibiotic use and shorten length of inpatient stay in children with suspected central nervous system infection by obtaining an early microbiological diagnosis. The clinical impact of the implementation of the BioFire FilmArray Meningitis/Encephalitis Panel on the management of childhood meningitis was evaluated at the John Radcliffe Hospital in Oxford and Children’s Health Ireland at Temple Street in Dublin.

Methods
Children who had lumbar punctures performed as part of a septic screen were identified retrospectively through clinical discharge coding and microbiology databases from April 2017 to December 2018. Anonymized clinical and laboratory data were collected. Comparison of antibiotic use, length of stay and outcome at discharge was made with a historical cohort in Oxford (2012–2016), presenting before implementation of the FilmArray.

Results
The study included 460 children who had a lumbar puncture as part of an evaluation for suspected central nervous system infection. Twelve bacterial cases were identified on the FilmArray that were not detected by conventional bacterial culture. Bacterial culture identified one additional case of bacterial meningitis, caused by Escherichia coli, which had not been identified on the FilmArray. Duration of antibiotics was shorter in children when FilmArray was used than before its implementation; enterovirus meningitis (median: 4 vs. 5 days), human parechovirus meningitis (median: 4 vs. 4.5 days) and culture/FilmArray-negative cerebrospinal fluid (median: 4 vs. 6 days).

Conclusions
The use of a FilmArray can identify additional bacterial cases of meningitis in children that had been negative by traditional culture methods. Children with viral meningitis and culture-negative meningitis received shorter courses of antibiotics and had shorter hospital stays when FilmArray was used. Large studies to evaluate the clinical impact and cost effectiveness of incorporating the FilmArray into routine testing are warranted.

Item Type: Article
Subjects: QW Microbiology and Immunology > QW 50 Bacteria (General). Bacteriology. Archaea
WS Pediatrics > WS 20 Research (General)
Faculty: Department: Education
Digital Object Identifer (DOI): https://doi.org/10.1097/inf.0000000000004236
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 29 Feb 2024 09:06
Last Modified: 20 Mar 2024 15:19
URI: https://archive.lstmed.ac.uk/id/eprint/23843

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