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. 2024 Feb 1;18(2):e13250.
doi: 10.1111/irv.13250. eCollection 2024 Feb.

Respiratory viral detection in the plasma and cerebrospinal fluid (CSF) of young febrile infants

Erin G Nicholson  1   2 , Vasanthi Avadhanula  1 , Leila C Sahni  2   3 , Laura Ferlic-Stark  1 , Lauren Maurer  1 , Julie A Boom  2 , Pedro A Piedra  1   2
Affiliations

Respiratory viral detection in the plasma and cerebrospinal fluid (CSF) of young febrile infants

Erin G Nicholson et al. Influenza Other Respir Viruses. .

Abstract

Background: Respiratory viral infections are common in febrile infants ≤90 days. However, the detection of viruses other than enterovirus in the blood and cerebrospinal fluid (CSF) of young infants is not well defined. We sought to quantify the occurrence of respiratory viruses in the blood and CSF of febrile infants ≤90 days.

Methods: We conducted a nested cohort study examining plasma and CSF samples from febrile infants 15-90 days via rtPCR. The samples were tested for respiratory viruses (respiratory syncytial virus, influenza, enterovirus, parechovirus, adenovirus, bocavirus). Clinical and laboratory data were also collected to determine the presence of serious bacterial infections (SBI).

Results: Twenty-four percent (30 of 126) of infants had plasma/CSF specimens positive for a respiratory virus. Enterovirus and parechovirus were the most commonly detected respiratory viruses. Viral positivity was highest in plasma samples at 25% (27 of 107) compared with CSF samples at 15% (nine of 62). SBIs (specifically urinary tract infections) were less common in infants with a sample positive for a respiratory virus compared to those without a virus detected (3% vs. 26%, p = 0.008).

Conclusions: Our findings support the use of molecular diagnostics to include the identification of parechovirus in addition to enterovirus in febrile infants ≤90 days. Additionally, these data support the utilization of blood specimens to diagnose enterovirus and parechovirus infections in febrile infants ≤90 days.

Keywords: enterovirus; febrile infants; parechovirus; respiratory viral infections; serious bacterial infections.

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Conflict of interest statement

The authors do not have any conflicts of interest to disclose with regard to the work.

Figures

FIGURE 1
FIGURE 1
The percentage of plasma and/or cerebrospinal fluid samples positive for a respiratory virus by rtPCR by the month of sample collection. Four viruses are described (enterovirus, parechovirus, adenovirus, and bocavirus). Respiratory syncytial virus and rhinovirus were also tested for but are not described because their detection rates were 0% throughout the study period.
FIGURE 2
FIGURE 2
The percentage of plasma and/or cerebrospinal fluid samples positive for a respiratory virus by rtPCR according to the age group of the infants. Four viruses are described (enterovirus, parechovirus, adenovirus, and bocavirus). Respiratory syncytial virus and rhinovirus were also tested for but are not described because their detection rates were 0% throughout the study period.
See this image and copyright information in PMC

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