Title: Title: Impact of Integrating the BioFire® Meningitis/ Encephalitis (ME) Panel with Antimicrobial Stewardship in a Non-Teaching Community Hospital
Study Location: Prisma Health Blount Memorial Hospital, Maryville, TN – Department of Pharmacy
Background: Limited data exists on the clinical and financial impact of rapid cerebrospinal fluid (CSF) diagnostic testing in non-academic community hospitals. This study evaluated the effect of implementing the BioFire® MEP on patient outcomes and hospital resource utilization.
Methods: This IRB-approved, single-center, retrospective cohort study included adults hospitalized from July 2020 through June 2025 with an identified CSF culture ordered. Exclusion criteria were if less than 18 years old, test cancellation or non-completion, transfer to another facility, repeat CSF specimens from the same patient or infection, or treated outpatient only. The primary outcome was time to optimal antimicrobial therapy in patients without the BioFire® MEP or with the BioFire® MEP. Secondary outcomes compared duration of antimicrobial therapy, hospital length of stay, and hospital costs per visit. Student’s t-tests were used with significance defined as p < 0.05.
Results: A total of one hundred and twenty-one patients were included: eighty-seven patients (72%) did not utilize the BioFire® MEP, and thirty-four patients (28%) utilized the BioFire® MEP. Median time to optimal antimicrobial therapy without the BioFire® MEP was 3.0 days compared to 2.0 days with the BioFire® MEP (absolute difference 1 day; 95% CI 0.004 to 1.96; p=0.04). Mean duration of antimicrobial therapy without the BioFire® MEP was 4.0 days compared to 2.9 days with the BioFire® MEP (absolute difference 1.1; 95% CI -2.72 to 0.56; p=0.19). Median hospital length of stay without the BioFire® MEP was 6.0 days compared to 4.5 days with the BioFire® MEP (absolute difference 1.5; 95% CI -1.74 to 4.74; p=0.36). Median hospital costs per visit without the BioFire® MEP were $8,456 compared to $9,854 with the BioFire® MEP (absolute difference $1,398).
Conclusion: In conclusion, this retrospective cohort study in a non-academic, community hospital, demonstrated that the implementation of the BioFire® MEP was associated with a significantly significant reduction in time to optimal antimicrobial therapy and potentially shorter antimicrobial duration and hospital length of stay. Additional large-scale studies are recommended to confirm these findings.
