Serpil S. ÇUĞLAN, Arzu İRVEM, Mahmure ASLAN, Derya ÇAKIR-ERDOĞAN, Gülşah E. ÖZMERDİVEN
Infectious Diseases and Clinical Microbiology - 2026;8(4):384-393
Objective: Rapid and accurate identification of central nervous system (CNS) pathogens is essential for appropriate antimicrobial management. This study aimed to evaluate the performance of the BioFire FilmArray Meningitis/Encephalitis (ME) Panel compared with conventional cerebrospinal fluid (CSF) analysis. Materials and Methods: This retrospective study was conducted at a tertiary care hospital over a three-year period. Cerebrospinal fluid samples were analyzed using routine microbiological methods (culture and Gram staining), cytological examination, biochemical testing, and multiplex PCR with the BioFire FilmArray ME Panel. Results: A total of 1470 CSF samples were analyzed, and pathogens were detected in 104 samples (7.1%), including 57 viral pathogens, 39 bacterial pathogens, one fungal pathogen, and six co-infections. Culture positivity was observed in one case each of Streptococcus pneumoniae and Cryptococcus neoformans, both concordant with PCR findings. Bacterial infections were associated with significantly lower CSF glucose levels (42.57 +/- 26.07 mg/dL) and higher lactate dehydrogenase (LDH) levels (320.33 +/- 455.76 IU/L) than viral infections (60.38 +/- 18.88 mg/dL and 53.08 +/- 26.85 IU/L, respectively). The proportion of polymorphonuclear leukocytes (PMNLs) was significantly higher in bacterial cases. Receiver operating characteristic (ROC) analysis demonstrated good discriminatory performance for LDH (area under the receiver operating characteristic curve [AUC] = 0.917) and PMNL percentage (AUC = 0.834). Viral pathogens were more frequent in the 0-2-year age group, whereas bacterial infections predominated in older children. Conclusion: The BioFire FilmArray ME Panel, when interpreted in conjunction with routine CSF biochemical and cytological parameters, provides a rapid and reliable diagnostic approach for differentiating bacterial from viral CNS infections.
