{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:22:12Z","timestamp":1791663732512,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The BioFire\u00ae FilmArray\u00ae Meningitis\/Encephalitis Panel (FA\/ME) (BioFire Diagnostics, LLC, Salt Lake City, UT, USA) is a multiplex polymerase chain reaction (PCR) assay which detects pathogens causing community\u2010acquired meningitis\/encephalitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to evaluate the performance, clinical impact and potential of a diagnostic stewardship algorithm to optimise FA\/ME use in an Australian tertiary hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study evaluated microbiological data from 712 patients who underwent FA\/ME testing between July 2018 and April 2024 at the Royal Melbourne Hospital and clinical data from a subset of 439 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The FA\/ME positivity rate was 12.2%. The panel showed 69.70% sensitivity and 93.04% specificity compared with comparator methods. FA\/ME positivity was associated with targeted antimicrobial therapy and shorter hospital stays. The cerebrospinal fluid white cell count (WCC) strongly predicted FA\/ME positivity (area under the curve\u2009=\u20090.80,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      A diagnostic stewardship algorithm employing a WCC threshold of &gt;50 \u00d7\u200910\n                      <jats:sup>6<\/jats:sup>\n                      \/L for FA\/ME testing, with reflex testing of specimens with lower WCC on an alternative viral multiplex PCR, would have reduced annual costs from $23\u2009302 (without stewardship) to $14\u2009646, doubled the positivity rate to 29.54% and detected all clinically significant infections. This study provides insights into optimising FA\/ME use in Australia to improve patient management.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70391","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T03:39:58Z","timestamp":1773459598000},"page":"849-857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficient use of the\n                    <scp>BioFire\u00ae FilmArray\u00ae<\/scp>\n                    Meningitis\/Encephalitis Panel: a diagnostic stewardship approach"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5970-9516","authenticated-orcid":false,"given":"Nalian H.","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Victorian Infectious Diseases Service The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kinsella","sequence":"additional","affiliation":[{"name":"Department of Microbiology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology and Immunology University of Melbourne at The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddie","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology and Immunology University of Melbourne at The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Cronin","sequence":"additional","affiliation":[{"name":"Victorian Infectious Diseases Service The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology and Immunology University of Melbourne at The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Bond","sequence":"additional","affiliation":[{"name":"Victorian Infectious Diseases Service The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Microbiology and Immunology University of Melbourne at The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"},{"name":"Victorian Infectious Diseases Reference Laboratory The Peter Doherty Institute for Infection and Immunity  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00195-3"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/425368"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2021.115605"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00070-09"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2024.01.010"},{"key":"e_1_2_8_7_1","unstructured":"bioM\u00e9rieux.BioFire Meningitis\/Encephalitis Panel. Accessed Accessed 5 Feb 2025 2025.https:\/\/www.biomerieux.com\/us\/en\/our-offer\/clinical-products\/biofire-meningitis-encephalitis-panel.html"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00730-16"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.11.016"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.05.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab467"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics9060282"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11081028"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1351903"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases10040110"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2025.116823"},{"key":"e_1_2_8_17_1","unstructured":"AusDiagnostics.AusDiagnostics Multiplexed diagnostics. 23 March 2025. Accessed 23 March 2025.https:\/\/www.ausdiagnostics.com\/"},{"key":"e_1_2_8_18_1","unstructured":"IMMY.CrAg(R) LFA Cryptococcal antigen. Accessed 23 March 2025.https:\/\/www.immy.com\/crag"},{"key":"e_1_2_8_19_1","unstructured":"Therapeutic Guidelines Limited.Antibiotic: Meningitis.https:\/\/tgldcdp.tg.org.au.acs.hcn.com.au\/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=meningitis&guidelinename=Antibiotic&sectionId=toc_d1e352#toc_d1e352"},{"key":"e_1_2_8_20_1","unstructured":"Therapeutic Guidelines Limited.2024.Antibiotic: Encephalitis.https:\/\/tgldcdp.tg.org.au.acs.hcn.com.au\/viewTopic?etgAccess=true&guidelinePage=Antibiotic&topicfile=encephalitis&guidelinename=Antibiotic&sectionId=toc_d1e87#toc_d1e87"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00311-20"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0804573"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000592"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy288"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae391"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.639658"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit458"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70391","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/imj.70391","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:21:33Z","timestamp":1779380493000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":26,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/imj.70391"],"URL":"https:\/\/doi.org\/10.1111\/imj.70391","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,13]]},"assertion":[{"value":"2025-10-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}