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

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

S C M de Crom  1 , C C Obihara, R A de Moor, E J M Veldkamp, A M van Furth, J W A Rossen
Affiliations
Comparative Study

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

S C M de Crom et al. J Clin Virol. 2013 Oct.

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.

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