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

Randy McCreery, Lindsey Nielsen, Dillon Clarey, Caitlin Murphy, Trevor C. Van Schooneveld

Research output: Contribution to journalArticlepeer-review

Abstract

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 <10 CSF WBC, but clinically significant results did occur in IC patients with low CSF WBC. Clinical decision support could reduce unneeded testing and result in significant cost savings.

Original languageEnglish (US)
Article number115605
JournalDiagnostic Microbiology and Infectious Disease
Volume102
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • BioFire Film Array
  • Diagnostic stewardship
  • ME panel
  • Meningitis
  • Meningitis panel

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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