title: High detection frequency and viral loads of human rhinovirus species A to C in fecal samples; diagnostic and clinical implications.
abstract: Human rhinoviruses (HRVs) can be divided into three species; HRV-A to HRV-C. Up to 148 different HRV (sero)types have been identified to date. Because of sequence similarity between 5'-NCR of HRVs and enteroviruses (EVs), it is problematic to design EV-specific RT-PCR assays. The aims of this study were to assess the rate of false-detection of different rhinoviruses by EV RT-PCR, and to evaluate the diagnostic and clinical significance of such cross-reactivity. In vitro RNA transcripts of HRV A-C created from cDNA templates were quantified spectrophotometrically. Six hundred twenty-one stool samples screened as part of routine diagnostic for EV, 17 EV-positive stool samples referred for typing, 288 stool samples submitted for gastroenteritis investigations, and 1,500 CSF samples were included in the study. EV-specific RT-PCR detected RNA transcripts of HRV-A1b, HRV-B14, and HRV-Crpat18 but with 10-1,000 reduced sensitivity compared to EV transcripts. Screening fecal samples by EV RT-PCR identified 13 positive samples identified subsequently as rhinoviruses; a further 26 HRV-positive samples were identified by nested HRV RT-PCR. All individuals were hospitalized and presented mostly with diarrhea. A total of 26 HRV types were identified (HRV-A: 46%; HRV-B: 13%; HRV-C: 41%). Results confirm that EV-specific RT-PCR can detect HRVs, and at a practical level, identify potential problems of interpretation if fecal samples are used for surrogate screening in cases of suspected viral meningitis. High detection frequencies (10%) and viral loads in stool samples provide evidence for enteric replication of HRV, and its association with enteric disease requires further etiological studies.
authors.affiliation: Specialist Virology Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. heli.simmonds@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Harvala
authors.forename: C L
authors.initials: CL
authors.lastname: McIntyre
authors.forename: N J
authors.initials: NJ
authors.lastname: McLeish
authors.forename: J
authors.initials: J
authors.lastname: Kondracka
authors.forename: J
authors.initials: J
authors.lastname: Palmer
authors.forename: P
authors.initials: P
authors.lastname: Molyneaux
authors.forename: R
authors.initials: R
authors.lastname: Gunson
authors.forename: S
authors.initials: S
authors.lastname: Bennett
authors.forename: K
authors.initials: K
authors.lastname: Templeton
authors.forename: P
authors.initials: P
authors.lastname: Simmonds
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004770:Enterovirus / Q000235:genetics; D004769:Enterovirus Infections / Q000175:diagnosis / Q000821:virology; D005243:Feces / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D010850:Picornaviridae Infections / Q000175:diagnosis* / Q000821:virology*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods; D012229:Rhinovirus / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D019562:Viral Load; D017201:Virus Shedding