THE CONTRIBUTION OF MOLECULAR BIOLOGY IN THE ETIOLOGICAL DIAGNOSIS OF INFECTIOUS MENINGITIS

Infectious meningitis is a vital emergency that needs rapid, efficient etiological diagnosis, and identification of the pathogens involved is crucial to reducing the health impact. The recent development of new syndromic multiplex PCR rapid diagnostic tests offers rapid, sensitive and specific diagnosis of infectious meningitis, even in cases of negative cultures or previous antibiotic therapy.
Our study evaluated the contribution of the FilmArray Meningitis/Encephalitis (M/E) panel to the diagnosis and management of infectious meningitis, comparing it with conventional culture, while highlighting the epidemiology of the pathogens implicated.
This retrospective study was carried out on 115 cerebrospinal fluid (CSF)  from patients clinically suspected of having meningitis, analyzed by conventional methods and the FilmArray M/E panel test.
The majority of specimens came from patients hospitalized at the Avicenne Military Hospital in Marrakech (91.5%), mainly from the emergency department (34%), with a male predominance (sex ratio M/F = 1.87). The FilmArray Meningitis/Encephalitis panel showed an overall positivity rate of 22.6%, revealing a viral etiology in 52% of cases (mainly enteroviruses, 26%), bacterial in 44% (notably Streptococcus pneumoniae, 15%), and cryptococcal in 4% in association with cytomegalovirus CMV. The test detected 23 cases of meningitis not identified by culture, and showed excellent concordance with the culture for pneumococcus (98.6%).
Median time to results was significantly reduced 5h compared with 48h for conventional methods.
The syndromic FilmArray Meningitis/Encephalitis multiplex PCR panel provides fast and accurate identification of infectious meningitis pathogens, supporting early and targeted therapeutic strategies. However, it should complement conventional microbiology and be interpreted within the clinical-epidemiological context.