Diagnosis of group A coxsackieviral infection using polymerase chain reaction

Abstract

Aims: To examine the relation between enteroviral infection, especially group A coxsackieviral infection, and acute febrile illness over two summers using tissue culture and polymerase chain reaction (PCR).

Methods: Throat swabs were collected from 246 children from June to August 1997 and 1998.

Results: Enteroviruses were isolated from 33/246 samples and 35 other viruses were isolated. Enteroviral genomes were detected in 54/178 samples from which no virus was isolated. Of 41 enteroviral genotypes identified by sequence analysis of PCR products, 38 were group A coxsackieviruses, which are usually difficult to isolate using tissue culture.

Conclusion: Results indicate that viral detection and identification based on PCR is useful in the diagnosis of group A coxsackieviral infection.

Figure 1

Phylogenetic tree of 64 prototype enteroviruses and 38 enteroviruses detected from patients with febrile illness during two summers. The phylogenetic tree was constructed based on the nucleotide sequences of the VP4 protein coding region. Sixty four prototype enterovirus strains were classified into four genetic clusters (A, B, C, and D). All 14 enteroviruses detected from patients with herpangina (Her), 8/11 enteroviruses detected from patients with febrile seizures (FS), and all 16 enteroviruses detected from patients with pharyngitis/tonsillitis (PT) were within the A cluster of enteroviruses (coxsackievirus group A-like genotype). Coxsackievirus group A-like genotypes detected from herpangina, febrile seizures, and pharyngitis/tonsillitis in two summers were distinctly clustered depending on the year when the samples were taken (1997 or 1998), rather than on the type of illness.