Clinical benefits of FilmArray meningitis-encephalitis PCR assay in partially-treated bacterial meningitis in Israel

BMC Infect Dis. 2019 Aug 13;19(1):713. doi: 10.1186/s12879-019-4348-x.

Abstract

Background: Management of partially-treated, community-acquired bacterial meningitis (PCBM) is commonly compromised by lack of microbiological diagnosis. We aimed to analyze the impact of FilmArray Meningitis-Encephalitis (FA-ME) PCR on the management of PCBM.

Methods: Comparison of treatment variables of PCBM cases between two periods, before (6.5 years, control group) and after (2 years, study group) the application of FA-ME PCR assay.

Results: The total duration of antimicrobial treatment in the study group (n = 8) was significantly shorter than the control group (n = 23) (9.5 ± 3.7 days vs. 15.2 ± 5 days, p = 0.007). The percentage of narrow-spectrum regimens was significantly higher in the study group (78 ± 11% vs. 40 ± 9%, p = 0.03). There was a significant difference in implementation of antimicrobial chemoprophylaxis for close contacts (4/8 (50%) vs. 1/23 (4%), p = 0.01).

Conclusions: The use of FA-ME PCR provides significant benefits in the management of PCBM by shortening duration of antibiotic treatment, increasing the use of narrow-spectrum regimens, and allowing proper administration of antimicrobial chemoprophylaxis.

Trial registration: The study was approved and retrospectively registered by the Tel-Aviv Sourasky Medical Center ( 0378-17-TLV , 10/17/2017) and Rabin Medical Center ( 0270-18-RMC , 11/11/2018) Ethics committees and conforms to recognized standards.

Keywords: Bacteriology; Meningitis; Polymerase chain reaction.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Chemoprevention
  • Cohort Studies
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / prevention & control
  • Encephalitis / diagnosis*
  • Encephalitis / genetics
  • Female
  • Humans
  • Israel
  • Male
  • Meningitis, Bacterial / diagnosis*
  • Meningitis, Bacterial / drug therapy*
  • Meningitis, Bacterial / epidemiology
  • Meningitis, Bacterial / prevention & control
  • Middle Aged
  • Polymerase Chain Reaction / methods*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents