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Meningitis/Encephalitis (M/E) Panel by Nucleic Acid Amplification

Viral, Virus, Bacterial, Bacterial, Fungal, Fungus, Escherichia coli K1, Haemophilus influenzae, Listeria monocytogenes, Streptococcus agalactiae, Group B Strep, Streptococcus pneumoniae, cytomegalovirus, CMV, Enterovirus, EV, Herpes simplex virus 1, Herpes simplex virus 2, HSV, Human herpesvirus 6, HHV6, Human parechovirus, HPeV, Varicella zoster virus, VZV

Test Codes

EPIC: LAB7060, SOFT: MEPNG

Department

Microbiology

Specimen Collection Criteria

Collect: ONE of the following specimen types:

• Cerebrospinal Fluid (CSF): 1.0 mL CSF in a sterile collection container. (Min: 0.25 mL) CSF specimens should be collected via lumbar puncture, and should not be centrifuged.

Special Specimen Collection and Handling Notes

• To minimize false positive test results, medical staff must wear a surgical mask and sterile gloves to avoid the inadvertent transfer of microorganisms from their bodies into the collection tubes during the lumbar puncture procedure.  Additionally, similar precautions should be extended to family members present during the procedure.

• This test should NOT be ordered on patients with an indwelling CNS medical device.

• Testing should only be performed on CSF collection tube (#2) designated for Microbiology.

• Testing will not be repeated on a patient within 30 days of the initial result, unless approved by an Infectious Diseases physician or the Medical or Technical Director of Microbiology.

Physician Office/Draw Specimen Preparation

Do not freeze specimens. Maintain room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: Room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Frozen specimens.
• Specimens not maintained in a sterile environment prior to receipt in the lab.

In-Lab Processing

Do not freeze specimens. Refrigerate (2-8°C or 36-46°F) specimens if testing will not be performed within 24 hours of the time of collection.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 30 days

Laboratory

Royal Oak Microbiology Laboratory.

Performed

Sunday - Saturday.
Results available within 12 hours.

Reference Range

Negative for all tested targets.

Test Methodology

FilmArray ME Panel (FDA-approved) – qualitative, multiplex Polymerase Chain Reaction (PCR) and high resolution melting curve analysis.

Interpretation

Negative.

A negative result does not rule out infection due to pathogens not included in this test.  This test will NOT replace standard-of-care culture and drug susceptibility testing.  This test can NOT  distinguish active or latent infections due to cytomegalovirus or human herpesvirus 6 (HHV6). This test can NOT detect non-K1 E. coli serotypes or non-encapsulated strains of Neisseria meningitidis.

Clinical Utility

This test is indicated as an aid in the diagnosis of specific agents of meningitis and/or encephalitis.  Test results should be used in conjunction with other clinical, epidemiological and laboratory data and NOT as the sole basis for diagnosis, treatment or patient management decisions.  Not all agents of CNS infection are detected by this test and positive results do not rule out co-infection with organisms not included in this assay.

This assay provides a rapid, highly sensitive and specific test for the detection of the following viruses, bacteria and fungi associated with meningitis and encephalitis.

Bacteria:

• Escherichia coli K1 *
• Haemophilus influenzae
• Listeria monocytogenes
• Neisseria meningitidis (encapsulated) *
• Streptococcus agalactiae
• Streptococcus pneumoniae

(*) This test can NOT detect non-K1 E. coli serotypes or non-encapsulated strains of Neisseria meningitidis.

Viruses:

• Cytomegalovirus *
• Enterovirus
• Herpes simplex virus 1
• Herpes simplex virus 2
• Human herpesvirus 6 *
• Human parechovirus
• Varicella zoster virus

(*) This test can NOT distinguish between latent or active infection due to cytomegalovirus (CMV) or Human Herpes virus 6 (HHV-6).

Yeast:

• Cryptococcus neoformans/gattii

Clinical Disease

Central nervous system (CNS) infections are responsible for causing inflammatory conditions of the brain and/or meningeal tissues surrounding the brain (i.e. meningitis, encephalitis, meningoencephalitis).  Approximately 15% of cases are fatal and many other cases result in life-long disabilities such as loss of limbs, visual and hearing deficits, seizures, and altered learning and memory.

Epidemiology

Variable

Incubation Period

Variable

Transmission

Variable

CPT Codes

87483
LOINC:  Escherichia coli K1 61398-4, Haemophilus influenza 61366-1, Listeria monocytogenes 61369-5, Streptococcus algalactiae 48683-7, Streptocococcus pneumoniae 49672-9, Cytomegalovirus 30326-3, Enterovirus 29558-4, Human Herpes Virus 6 33942-4, Herpes Simplex Virus 1 16952-4, Herpes Simplex Virus 2 16960-7, Human Parechovirus 51669-0, Varicella Zoster Virus 21598-8

Contacts

Last Updated

4/8/2024