Application of BioFire Meningitis Panel for Pathogen Identification and its Impact on Antimicrobial Therapy in Meningitis Cases at a Tertiary Care Centre in India

Background and Aim: Meningitis remains a significant public health issue in India to date for particular groups of people, including children, older adults and immunocompromised. This study aimed to evaluate the diagnostic performance, clinical usefulness and cost-effectiveness of a panel of 500 patients in the Indian setting. Materials and Methods: This prospective, observational study was conducted in a tertiary care hospital in India for one year after fulfilling the inclusion and exclusion criteria. The sensitivity and specificity of BioFire meningitis/encephalitis panel and conventional methods (culture, gram staining, and biochemical analysis) were computed to assess the diagnostic capabilities of each strategy with actual, clinically confirmed cases to illustrate differences in pathogen detection. Result: BioFire meningitis/encephalitis panel tested a sensitivity of 96% and a specificity of 98% for bacterial, viral, and fungal pathogens compared to conventional diagnostic approaches which shows reduced sensitivity. The BioFire Panel identified bacterial Meningitis in 28% of cases as Streptococcus pneumoniae, Neisseria meningitidis in 18%, and Mycobacterium tuberculosis in 15%. There were 44 cases of viral Meningitis, of which 32% were due to Enteroviruses, 14% were due to Herpes Simplex Virus 2 and 8% were fungal Meningitis, especially Cryptococcus neoformans. Conclusion: The BioFire meningitis/encephalitis panel test is better diagnostic tool in diagnosing meningitis than the conventional methods and should be included in the national guidelines for meningitis management.