Prospective comparison of culture vs genome detection for diagnosis of enteroviral meningitis in childhood.
OBJECTIVE
To assess the sensitivity and specificity of a new polymerase chain reaction (PCR) assay with uninterrupted reverse transcription and complementary DNA amplification (RT-PCR) for the diagnosis of enteroviral (EV) meningitis in children.


METHODS
A prospective, cohort study.


METHODS
Two medical centers: 1 university hospital and 1 children's hospital in San Diego County, California, during a 5-week period.


METHODS
All pediatric patients younger than 16 years who underwent a lumbar puncture for evaluation of possible meningitis.


METHODS
The results of cerebrospinal fluid (CSF) RT-PCR were compared with viral cultures and clinical histories.


RESULTS
During the 5-week period, 90 patients were entered into the study. Nonpolio EVs were cultured from 10% (9/90) of the patients from the following sites: CSF, 6.7% (6/90) of the patients; stool, 19% (4/21) of the patients; and throat swabs, 5.6% (1/18) of the patients. The EV genome was detected in the CSF by using RT-PCR in 7 of 9 EV culture-positive patients. The sensitivity and specificity of the CSF RT-PCR assay to detect EV meningitis were 77.8% and 100%, respectively. This compared with a sensitivity of 66.7% for detection of EV in CSF by viral culture alone.


CONCLUSIONS
The new RT-PCR assay is a rapid and reliable method for the detection of EV infection in childhood.
Tanel
R E
RE
Department of pediatrics, School of Medicine, University of California-San Diego, La Jolla, USA.
Kao
S Y
SY
Niemiec
T M
TM
Loeffelholz
M J
MJ
Holland
D T
DT
Shoaf
L A
LA
Stucky
E R
ER
Burns
J C
JC
D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000235:genetics*; D004769:Enterovirus Infections / Q000134:cerebrospinal fluid* / Q000821:virology; D016679:Genome, Viral; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid* / Q000821:virology; D016133:Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014158:Transcription, Genetic; D014776:Virus Cultivation / Q000379:methods*