[Rapid enterovirus genotyping in cerebrospinal fluids: a two-year prospective study in a virology laboratory setting].
Enterovirus (EV - 68 serotypes) infections comprise a wide spectrum of clinical presentations including infections of the central nervous system. In severe clinical presentation or epidemics, the precise identification of the involved serotype is necessary.


OBJECTIVE
To perform enterovirus genotyping directly in cerebrospinal fluid (CSF) samples, and to assess its feasibility in a laboratory setting.


METHODS
Enterovirus genotyping was carried out directly with CSF specimens tested for the diagnostic procedure by amplifying the complete 1D gene encoding the VP1 protein of the HEV-B serotypes (the most frequent) - providing results in two days. Secondly, sequences 1A/1B encoding the VP4/VP2 capsid proteins, respectively, were analysed (results in five days).


RESULTS
Direct enterovirus genotyping allowed the identification of enterovirus involved in 77 out of 81 (95%) meningitis cases between January 2006 and December 2007. In combination with the indirect genotyping of enterovirus isolates, identification of the type was achieved in 94 out of 97 (96.9%) patients included in the study. The most frequent serotypes were echovirus 6 (E6) and 13 in 2006, coxsackievirus B2 and E30 in 2007. Four children presented an EV71 associated meningitis.


CONCLUSIONS
When prospectively applied in a laboratory setting, direct enterovirus genotyping in CSF samples allows the identification of the involved enterovirus in two to five days. This time frame is relevant for an optimal patient management, the rapid identification of a new enterovirus variant or in the context of an epidemic alert.
Mirand
A
A
Laboratoire de virologie, centre de biologie, CHU de Clermont-Ferrand, 58, rue Montalembert, 63003 Clermont-Ferrand, France. amirand@chu-clermontferrand.fr
Bailly
J-L
JL
Henquell
C
C
Peigue-Lafeuille
H
H
D036022:Capsid Proteins / Q000235:genetics; D002555:Cerebrospinal Fluid / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D003384:Coxsackievirus Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000821:virology; D004457:Echovirus Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000821:virology; D004770:Enterovirus / Q000145:classification* / Q000235:genetics; D029822:Enterovirus B, Human / Q000235:genetics / Q000302:isolation & purification; D030015:Enterovirus C, Human / Q000235:genetics / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology / Q000821:virology; D005240:Feasibility Studies; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007231:Infant, Newborn; D007753:Laboratories; D008297:Male; D008587:Meningitis, Viral / Q000134:cerebrospinal fluid / Q000821:virology; D010802:Phylogeny; D011446:Prospective Studies; D012367:RNA, Viral / Q000235:genetics; D014773:Virology / Q000379:methods*; D014776:Virus Cultivation
D036022:Capsid Proteins; D012367:RNA, Viral
Génotypage direct rapide des entérovirus dans le liquide céphalorachidien : étude prospective de deux ans au sein d'un laboratoire de virologie clinique.