Patients
This was a descriptive, observational, retrospective analysis using data from the Microbiology Laboratory of Mohammed VI University Hospital of Marrakech. This study covered a period of 34 months between March 2018 and December 2020 and included all patients (adults and children) hospitalized in different intensive care units of Mohammed VI University Hospital of Marrakech who underwent a multiplex FilmArray® meningitis/encephalitis panel (FA MEP) PCR on a cerebrospinal fluid (CSF) sample. The Mohammed VI University Hospital of Marrakech is the only tertiary hospital in the region that receives patients referred from the south of Morocco.
This study included all pediatric and adult patients with suspected severe acute meningeal infection for whom the clinician had ordered meningeal PCR for an infectious etiology. Cerebrospinal fluid was collected by lumbar or transfontanellar puncture [1 (link),2 (link)].
Methods
After receiving the samples, the culture was performed first with the cytobacteriological examination, followed by a multiplex PCR search for microbial agents. The culture was conducted for all samples, while the PCR was only performed based on microbiological criteria (high cytology, hypoglycorrhachia, and high CSF proteins) or at the request of the clinician.
The cytobacteriological and biochemical study of the CSF was performed according to the standard procedures of the French Society of Microbiology. Protein and glucose concentrations were measured by immunoturbidimetric assay using the Roche/Hitachi Cobas 311 system (Basel, Switzerland) with calibrators and internal controls supplied by Roche and according to the manufacturer’s recommendations.
FilmArray® Meningitis/Encephalitis Panel (FA MEP) TestApproximately 200 μL of CSF was used for the BioFire® FilmArray® meningitis/encephalitis panel PCR panel according to the manufacturer’s recommendations. This multiplex real-time PCR assay consists of an automated nucleic acid assay based on acid extraction, reverse transcription, and nucleic acid amplification, with an average result turnaround time of 75 minutes per run and a handling time of less than five minutes. Transportation of samples from clinical services to the laboratory typically took about 15 minutes.
This PCR detects 14 pathogens: Cytomegalovirus, Enterovirus, Herpes simplex virus (HSV) 1/2, HHV-6, Parechovirus, Varicella-zoster virus, Cryptococcus neoformans/gattii, Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus agalactiae, and Streptococcus pneumoniae.
Statistical analysis
All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM SPSS Statistics, Armonk, NY, USA) and Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Statistical comparisons were performed using the chi-square test. A probability value (p) of less than 0.05 was considered statistically significant.
This was a descriptive, observational, retrospective analysis using data from the Microbiology Laboratory of Mohammed VI University Hospital of Marrakech. This study covered a period of 34 months between March 2018 and December 2020 and included all patients (adults and children) hospitalized in different intensive care units of Mohammed VI University Hospital of Marrakech who underwent a multiplex FilmArray® meningitis/encephalitis panel (FA MEP) PCR on a cerebrospinal fluid (CSF) sample. The Mohammed VI University Hospital of Marrakech is the only tertiary hospital in the region that receives patients referred from the south of Morocco.
This study included all pediatric and adult patients with suspected severe acute meningeal infection for whom the clinician had ordered meningeal PCR for an infectious etiology. Cerebrospinal fluid was collected by lumbar or transfontanellar puncture [1 (link),2 (link)].
Methods
After receiving the samples, the culture was performed first with the cytobacteriological examination, followed by a multiplex PCR search for microbial agents. The culture was conducted for all samples, while the PCR was only performed based on microbiological criteria (high cytology, hypoglycorrhachia, and high CSF proteins) or at the request of the clinician.
The cytobacteriological and biochemical study of the CSF was performed according to the standard procedures of the French Society of Microbiology. Protein and glucose concentrations were measured by immunoturbidimetric assay using the Roche/Hitachi Cobas 311 system (Basel, Switzerland) with calibrators and internal controls supplied by Roche and according to the manufacturer’s recommendations.
FilmArray® Meningitis/Encephalitis Panel (FA MEP) TestApproximately 200 μL of CSF was used for the BioFire® FilmArray® meningitis/encephalitis panel PCR panel according to the manufacturer’s recommendations. This multiplex real-time PCR assay consists of an automated nucleic acid assay based on acid extraction, reverse transcription, and nucleic acid amplification, with an average result turnaround time of 75 minutes per run and a handling time of less than five minutes. Transportation of samples from clinical services to the laboratory typically took about 15 minutes.
This PCR detects 14 pathogens: Cytomegalovirus, Enterovirus, Herpes simplex virus (HSV) 1/2, HHV-6, Parechovirus, Varicella-zoster virus, Cryptococcus neoformans/gattii, Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Neisseria meningitidis, Streptococcus agalactiae, and Streptococcus pneumoniae.
Statistical analysis
All statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM SPSS Statistics, Armonk, NY, USA) and Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Statistical comparisons were performed using the chi-square test. A probability value (p) of less than 0.05 was considered statistically significant.
Free full text: Click here
