[Analysis of 187 children with enteroviral central nervous system infection in Shandong area].
OBJECTIVE
To evaluate the diagnostic potential of previously published enterovirus (EV) reverse transcription polymerase chain reaction (RT-PCR) assay in detection of EV in CSF samples from children with a diagnosis of aseptic meningitis and to investigate the clinical characteristics of the patients seen in Shandong.


METHODS
EV RNA was detected in 187 CSF samples and serum and/or urine samples of a part of patients by RT-PCR and viral culture technique.


RESULTS
RT-PCR was positive in all 62 CSF specimens which were positive by cell culture (100%). In addition, 93 of 125 (74.4%) CSF samples negative by cell culture were RT-PCR positive. In 4 of these 93 (4.3%) patients, viral culture of specimens from other sites (serum or urine) was also positive. The sensitivity of CSF RT-PCR based on clinical diagnosis in patients with meningitis of negative bacterial culture results was 82.9% (155/187), which was considerably higher than the sensitivity of CSF virus culture 33.2% (62/187). The results of RT-PCR can be reported within 4 hours, whereas the viral culture of CSF requires 4.6 days for a cytopathic effect to develop. EV meningitis occurred in a sporadic form and in some areas there were outbreaks. The clinical characteristics of 155 patients with EV meningitis were different in different age groups.


CONCLUSIONS
EV was one of the most common causes of aseptic meningitis in Shandong area. The RT-PCR assay was rapid, sensitive and specific for the diagnosis of EV meningitis and may be a potential tests to shorten hospital stay and reduce the use of antibiotics.
Chen
Zong-bo
ZB
Department of Pediatrics, The Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003 China.
Fan
Xi-wen
XW
Dong
Yong-sui
YS
Sun
Jin-qiao
JQ
Liu
Yuan-chang
YC
D002494:Central Nervous System Infections / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D002648:Child; D002675:Child, Preschool; D002681:China; D004770:Enterovirus / Q000235:genetics / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D005260:Female; D006367:HeLa Cells; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012367:RNA, Viral / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction
D012367:RNA, Viral