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. 2022 Mar 18;19(1):45.
doi: 10.1186/s12985-022-01770-w.

Molecular characterization of enterovirus detected in cerebrospinal fluid and wastewater samples in Monastir, Tunisia, 2014-2017

Yosra Rmadi  1 , Aida Elargoubi  2 , Rubén González-Sanz  3 , Maha Mastouri  1   2 , Maria Cabrerizo #  4 , Mahjoub Aouni #  1
Affiliations

Molecular characterization of enterovirus detected in cerebrospinal fluid and wastewater samples in Monastir, Tunisia, 2014-2017

Yosra Rmadi et al. Virol J. .

Abstract

Background: Enteroviruses (EVs) are considered the main causative agents responsible for aseptic meningitis worldwide. This study was conducted in the Monastir region of Tunisia in order to know the prevalence of EV infections in children with meningitis symptoms. Detected EV types were compared to those identified in wastewater samples.

Methods: Two hundred CSF samples collected from hospitalized patients suspected of having aseptic meningitis for an EV infection between May 2014 and May 2017 and 80 wastewater samples collected in the same time-period were analyzed. EV detection and genotyping were performed using PCR methods followed by sequencing. Phylogenetic analyses in the 3'-VP1 region were also carried-out.

Results: EVs were detected in 12% (24/200) CSF and in 35% (28/80) wastewater samples. EV genotyping was reached in 50% (12/24) CSF-positive samples and in 64% (18/28) sewage. Most frequent types detected in CSF were CVB3, E-30 and E-9 (25% each). In wastewater samples, the same EVs were identified, but also other types non-detected in CSF samples, such as E-17,CVA9 and CVB1 from EV species B, and EV-A71 and CVA8 from EV-A, suggesting their likely lower pathogenicity. Phylogenetic analysis showed that within the same type, different strains circulate in Tunisia. For some of the EV types such as E-9, E-11 or CVB3, the same strains were detected in CSF and wastewater samples.

Conclusions: Epidemiological studies are important for the surveillance of the EV infections and to better understand the emergence of certain types and variants.

Keywords: Enteroviruses; Meningitis; Phylogenetic analysis; Wastewater.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Monthly distribution of EV infections detected in clinical and wastewater (ww) samples from this study
Fig. 2
Fig. 2
Phylogenetic trees of EV-B (a) and EV-A (b) sequences isolated in this study, prototype strains and others available in GenBank based on 3′-VP1 gene sequence. Tunisian strains isolated in this study are indicated with black circle. The trees were rooted with the EV-D68 Fermon sequence. Only bootstraps > 70 are indicated
Fig. 2
Fig. 2
Phylogenetic trees of EV-B (a) and EV-A (b) sequences isolated in this study, prototype strains and others available in GenBank based on 3′-VP1 gene sequence. Tunisian strains isolated in this study are indicated with black circle. The trees were rooted with the EV-D68 Fermon sequence. Only bootstraps > 70 are indicated
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References

    1. Zell R, Delwart E, Gorbalenya AE, Hovi T, King AMQ, Knowles NJ, et al. ICTV virus taxonomy profile: picornaviridae. J Gen Virol. 2017;98(10):2421–2422. - PMC - PubMed
    1. Baggen J, Thibaut HJ, Strating JRPM, van Kuppeveld FJM. The life cycle of non-polio enteroviruses and how to target it. Nat Rev Microbiol. 2018;16(6):368–381. - PubMed
    1. Simmonds P, Gorbalenya AE, Harvala H, Hovi T, Knowles NJ, Lindberg AM, et al. Recommendations for the nomenclature of enteroviruses and rhinoviruses. Arch Virol. 2020;165(3):793–797. - PMC - PubMed
    1. Huang H-I, Shih S-R. Neurotropic enterovirus infections in the central nervous system. Viruses. 2015;7(11):6051–6066. - PMC - PubMed
    1. Muehlenbachs A, Bhatnagar J, Zaki SR. Tissue tropism, pathology and pathogenesis of enterovirus infection: tissue tropism, pathology and pathogenesis of enterovirus infection. J Pathol. 2015;235(2):217–228. - PubMed

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