Trends in the Causes of Meningitis/Encephalitis Analyzed Using the BioFire FilmArray Panel

Abstract

Cerebrospinal Fluid (CSF) infections can be caused by various pathogens, including bacteria, viruses, and fungi. Therefore, accurate and timely detection of infectious agents is critical for the effective treatment of CSF infections. The FilmArray Meningitis/Encephalitis (M/E) panel is a potential complementary diagnostic tool for detecting CSF pathogens. The aim of this study was to identify trends in the causes of meningitis/encephalitis by analyzing pathogens, coinfection, age, sex, and infection timing in patients with suspected encephalitis/meningitis using the FilmArray M/E panel results. We analyzed 2,335 cerebrospinal fluid samples collected between December 2017 and February 2023. Additionally, we assessed the potential benefits and limitations of the FilmArray M/E test and identified clinically meaningful application methods. Of the total samples, 219 (9.4%) were positive; one triple infection and two double infections were also identified. Among the positive cases, 54.6% were men. Human herpes virus 6, varicella-zoster virus, and herpes simplex virus 1 were the most commonly identified pathogens with positivity rates of 49.78% (111/223), 17.94% (40/223), and 13.90% (31/223), respectively. Of the total positive samples, 56.1% (125) samples were obtained from July to December and 50.4% (113) were distributed in the 0-17-year age group. The FilmArray M/E panel provides a comprehensive and rapid way to identify CSF pathogens; it can help select appropriate treatments for target pathogens and track the epidemiology of CSF infections. Conducting research using cerebrospinal fluid is challenging owing to difficulties in its collection and manipulation. This study is novel and significant in that it comprehensively analyzed meningitis/encephalitis using FilmArray M/E panel in 2,335 large-scale CSF samples.