Prospective comparison of the detection rates of human enterovirus and parechovirus RT-qPCR and viral culture in different pediatric specimens

J Clin Virol. 2013 Oct;58(2):449-54. doi: 10.1016/j.jcv.2013.07.017. Epub 2013 Aug 21.

Abstract

Background: Reverse-transcriptase quantitative real-time polymerase chain reaction (RT-qPCR) has become the gold standard for the diagnosis of human enterovirus (EV) and parechovirus (HPeV) infections. The detection rate of RT-qPCR in different pediatric body specimens has not been compared prospectively in a multicentre study.

Objectives: This study compared the diagnostic detection rates of EV and HPeV RT-qPCR and viral culture in different specimens (feces, nasopharynx, blood, urine and cerebrospinal fluid (CSF)) of pediatric patients.

Study design: This prospective, multicenter study performed an EV and HPeV RT-qPCR on nasopharynx, blood, urine, feces and CSF specimens and a viral culture on nasopharynx, feces and CSF specimens in symptomatic children<16 years.

Results: Of 285 included children EV was detected in 140 (49%) and HPeV in 44 (15%) children. Both EV and HPeV RT-qPCR had a higher sensitivity and negative predictive value than EV and HPeV viral culture, respectively. EV and HPeV RT-qPCR in feces specimen had the highest sensitivity (99.2% and 95.1%) of all specimens. Pooling results of specimens increased the detection rate for both viruses.

Conclusion: Of all specimens, RT-qPCR in feces had the highest detection rate for both EV and HPeV in symptomatic pediatric patients. An EV was detected in all EV positive patients if a RT-qPCR was performed on both feces and CSF specimens or in both feces and urine specimens. HPeV was detected in all HPeV positive patients if a RT-qPCR was performed on both feces and CSF specimens, feces and nasopharynx specimens or CSF and nasopharynx specimens.

Keywords: CSF; EV; Enterovirus; HEp-2; HPeV; Human parechovirus; NPV; PPV; Pediatric; RNA; RT-qPCR; Viral culture; cerebrospinal fluid; cynomolgus monkey kidney; human epidermoid cancer; human non-polio enterovirus; human parechovirus; negative predictive value; positive predictive value; reverse-transcriptase real time quantitative polymerase chain reaction; ribonucleic acid; tMK.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Enterovirus / isolation & purification*
  • Enterovirus Infections / diagnosis*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Molecular Diagnostic Techniques / methods*
  • Parechovirus / isolation & purification*
  • Picornaviridae Infections / diagnosis*
  • Predictive Value of Tests
  • Prospective Studies
  • Real-Time Polymerase Chain Reaction / methods*
  • Reverse Transcriptase Polymerase Chain Reaction / methods*
  • Sensitivity and Specificity
  • Virus Cultivation / methods