Diagnostic Performance of the FilmArray® Meningitis/Encephalitis Panel for the Detection of Central Nervous System Infections in a Tertiary Care University Hospital in Tangier, Morocco

Background: Central nervous system (CNS) infections represent serious medical emergencies. The development of syndromic tests has improved clinical management. The FilmArray® Meningitis/Encephalitis (ME) panel (BioFire Diagnostics, Salt Lake City, Utah) is an automated multiplex polymerase chain reaction (PCR) assay capable of simultaneously detecting 14 CNS pathogens from small cerebrospinal fluid (CSF) volumes. This study aimed to assess the diagnostic performance of this panel compared with conventional microbiological methods. Methods: A retrospective diagnostic accuracy study was conducted in the microbiology laboratory of Mohammed VI University Hospital in Tangier, Morocco, between June 2023 and May 2025. Conventional methods included Gram staining, bacterial and fungal cultures, and cryptococcal antigen testing. The comparative analysis was limited to bacterial and fungal pathogens, using culture as the reference standard. Results: Among the 402 samples analyzed, at least one pathogen was detected in 60 cases (14.9%). Viral pathogens were the most common (51.7%), followed by bacterial pathogens (40.0%), whereas fungal detection was rare (1.7%). Four cases of bacterial-viral co-detection (6.7%) were observed. For the detection of bacterial and fungal pathogens included in the panel, the FilmArray® ME panel demonstrated a sensitivity of 100%, a specificity of 94.9%, a positive predictive value (PPV) of 31.0%, and a negative predictive value (NPV) of 100%. Agreement between the FilmArray® ME panel and conventional culture was moderate (κ = 0.455), with culture confirmation obtained in 9 of 29 FilmArray®-positive bacterial and fungal cases. Conclusion: The FilmArray® ME panel represents a valuable rapid adjunctive diagnostic tool for CNS infections. However, interpretation of its results should be integrated with clinical and conventional laboratory findings, particularly given its limited pathogen spectrum, including the absence of Mycobacterium tuberculosis detection.