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Point-Counterpoint

Point-Counterpoint: Meningitis/Encephalitis Syndromic Testing in the Clinical Laboratory

Jennifer Dien Bard, Kevin Alby
Nathan A. Ledeboer, Editor
Jennifer Dien Bard
aDepartment of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA
bKeck School of Medicine, University of Southern California, Los Angeles, California, USA
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Kevin Alby
cPathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
dClinical Microbiology Lab, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Nathan A. Ledeboer
Medical College of Wisconsin
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DOI: 10.1128/JCM.00018-18
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INTRODUCTION

Syndromic panels were first FDA cleared for detection of respiratory pathogens in 2008. Since then, other panels have been approved by the FDA, and most recently, the FilmArray meningitis/encephalitis panel (BioFire, Salt Lake City, UT) has become available. This assay detects 14 targets within 1 h and includes pathogens that typically cause different manifestations of infection, although they infect the same organ system. Several studies have reported both false-positive and false-negative results with this test, and all agree that the cost is significant. As with other panels, health care systems have adopted different strategies for offering this assay. Some have implemented strategies to limit the use of the test to certain patient populations, others have elected not to offer the test, and others have elected not to offer the test and instead request that providers order specific PCRs for the pathogens that best fit the patient's symptoms. In this Point-Counterpoint, Jennifer Dien Bard of the Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, and of the Keck School of Medicine at the University of Southern California explains why laboratories should offer these assays without restriction. Kevin Alby of the University of Pennsylvania explains the concerns about the use of these assays as first-line tests and why some limitations on their use might be appropriate.

The views expressed in this feature do not necessarily represent the views of the journal or of ASM.

  • Copyright © 2018 American Society for Microbiology.

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Point-Counterpoint: Meningitis/Encephalitis Syndromic Testing in the Clinical Laboratory
Jennifer Dien Bard, Kevin Alby
Journal of Clinical Microbiology Mar 2018, 56 (4) e00018-18; DOI: 10.1128/JCM.00018-18

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Point-Counterpoint: Meningitis/Encephalitis Syndromic Testing in the Clinical Laboratory
Jennifer Dien Bard, Kevin Alby
Journal of Clinical Microbiology Mar 2018, 56 (4) e00018-18; DOI: 10.1128/JCM.00018-18
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KEYWORDS

Neisseria meningitidis
Biofire
encephalitis
enterovirus
film array
herpes simplex virus
lab utilization
Streptococcus pneumoniae

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