Efficient use of the BioFire® FilmArray® Meningitis/Encephalitis Panel: a diagnostic stewardship approach.

IF 1.5 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Internal Medicine Journal Pub Date : 2026-03-13 DOI:10.1111/imj.70391

Nalian H Ibrahim, Paul Kinsella, Eddie Chan, Katie Cronin, Katherine Bond

{"title":"Efficient use of the BioFire® FilmArray® Meningitis/Encephalitis Panel: a diagnostic stewardship approach.","authors":"Nalian H Ibrahim, Paul Kinsella, Eddie Chan, Katie Cronin, Katherine Bond","doi":"10.1111/imj.70391","DOIUrl":null,"url":null,"abstract":"Background: The BioFire® FilmArray® Meningitis/Encephalitis Panel (FA/ME) (BioFire Diagnostics, LLC, Salt Lake City, UT, USA) is a multiplex polymerase chain reaction (PCR) assay which detects pathogens causing community-acquired meningitis/encephalitis.Aims: This study aimed to evaluate the performance, clinical impact and potential of a diagnostic stewardship algorithm to optimise FA/ME use in an Australian tertiary hospital.Methods: This retrospective study evaluated microbiological data from 712 patients who underwent FA/ME testing between July 2018 and April 2024 at the Royal Melbourne Hospital and clinical data from a subset of 439 patients.Results: The FA/ME positivity rate was 12.2%. The panel showed 69.70% sensitivity and 93.04% specificity compared with comparator methods. FA/ME positivity was associated with targeted antimicrobial therapy and shorter hospital stays. The cerebrospinal fluid white cell count (WCC) strongly predicted FA/ME positivity (area under the curve = 0.80, P < 0.0001).Conclusions: A diagnostic stewardship algorithm employing a WCC threshold of >50 × 106/L for FA/ME testing, with reflex testing of specimens with lower WCC on an alternative viral multiplex PCR, would have reduced annual costs from $23 302 (without stewardship) to $14 646, doubled the positivity rate to 29.54% and detected all clinically significant infections. This study provides insights into optimising FA/ME use in Australia to improve patient management.","PeriodicalId":13625,"journal":{"name":"Internal Medicine Journal","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Internal Medicine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/imj.70391","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The BioFire® FilmArray® Meningitis/Encephalitis Panel (FA/ME) (BioFire Diagnostics, LLC, Salt Lake City, UT, USA) is a multiplex polymerase chain reaction (PCR) assay which detects pathogens causing community-acquired meningitis/encephalitis.

Aims: This study aimed to evaluate the performance, clinical impact and potential of a diagnostic stewardship algorithm to optimise FA/ME use in an Australian tertiary hospital.

Methods: This retrospective study evaluated microbiological data from 712 patients who underwent FA/ME testing between July 2018 and April 2024 at the Royal Melbourne Hospital and clinical data from a subset of 439 patients.

Results: The FA/ME positivity rate was 12.2%. The panel showed 69.70% sensitivity and 93.04% specificity compared with comparator methods. FA/ME positivity was associated with targeted antimicrobial therapy and shorter hospital stays. The cerebrospinal fluid white cell count (WCC) strongly predicted FA/ME positivity (area under the curve = 0.80, P < 0.0001).

Conclusions: A diagnostic stewardship algorithm employing a WCC threshold of >50 × 10⁶/L for FA/ME testing, with reflex testing of specimens with lower WCC on an alternative viral multiplex PCR, would have reduced annual costs from $23 302 (without stewardship) to $14 646, doubled the positivity rate to 29.54% and detected all clinically significant infections. This study provides insights into optimising FA/ME use in Australia to improve patient management.

查看原文本刊更多论文

有效使用BioFire®FilmArray®脑膜炎/脑炎小组：一种诊断管理方法

背景：BioFire®FilmArray®脑膜炎/脑炎小组（FA/ME）（BioFire Diagnostics， LLC, Salt Lake City， UT， USA）是一种多重聚合酶链反应（PCR）检测方法，用于检测引起社区获得性脑膜炎/脑炎的病原体。目的：本研究旨在评估诊断管理算法的性能，临床影响和潜力，以优化FA/ME在澳大利亚三级医院的使用。方法：本回顾性研究评估了2018年7月至2024年4月期间在皇家墨尔本医院接受FA/ME检测的712名患者的微生物学数据和439名患者的临床数据。结果：FA/ME阳性率为12.2%。与比较方法相比，该方法的敏感性为69.70%，特异性为93.04%。FA/ME阳性与靶向抗菌药物治疗和较短的住院时间有关。结论：采用WCC阈值为bbb50 × 106/L的FA/ME检测诊断管理算法，对WCC较低的标本进行选择性病毒复合PCR反射检测，可将年度成本从23302美元（无管理）降低至14646美元，将阳性率提高一倍至29.54%，并检测出所有临床显著感染。本研究为优化FA/ME在澳大利亚的使用以改善患者管理提供了见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Internal Medicine Journal 医学-医学：内科

CiteScore

3.50

自引率

4.80%

发文量

600

审稿时长

3-6 weeks

期刊介绍： The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.