Evaluation of cerebrospinal fluid white blood cell count criteria for use of the BioFire® FilmArray® Meningitis/Encephalitis Panel in immunocompromised and nonimmunocompromised patients

• Published in: Diagnostic microbiology and infectious disease 2022-03, Vol.102 (3), p.115605-115605, Article 115605
• Main Authors: McCreery, Randy, Nielsen, Lindsey, Clarey, Dillon, Murphy, Caitlin, Van Schooneveld, Trevor C.
• Format: Article
• Language: English
• Subjects: BioFire Film Array; Cerebrospinal Fluid; Diagnostic stewardship; Encephalitis; Humans; Immunocompromised Host; Leukocyte Count; ME panel; Meningitis; Meningitis panel; Multiplex Polymerase Chain Reaction
• ISSN: 0732-8893; 1879-0070
• DOI: 10.1016/j.diagmicrobio.2021.115605

We implemented the BioFire® FilmArray® Meningitis/Encephalitis Panel (MEP) with guidance for use based on patient age, cerebrospinal fluid (CSF) white blood cell (WBC) count and immune system status. MEPs results over 2 years (1/1/2017 to 12/31/18) were reviewed and clinical significance of positive MEP results in patients with CSF WBC ≤ 10 evaluated. Overall, 12% (51/453) of MEPs were positive with 4/184 (2%) positive in nonimmunocompromised (non-IC) with ≤ 10 CSF WBCs. Among positive results in non-IC patient with ≤10 CSF WBCs, none were judged clinically significant. Four of 6 results in immunocompromised patients with ≤10 CSF WBCs were clinically significant. Redundant testing was common and guideline adherence could have safely decreased MEPs use 41% saving >$56,000. Guideline adherence was poor and MEP use can be safely avoided in non-IC adults with