title: Prospective comparison of the detection rates of human enterovirus and parechovirus RT-qPCR and viral culture in different pediatric specimens.
abstract: BACKGROUND
  Reverse-transcriptase quantitative real-time polymerase chain reaction (RT-qPCR) has become the gold standard for the diagnosis of human enterovirus (EV) and parechovirus (HPeV) infections. The detection rate of RT-qPCR in different pediatric body specimens has not been compared prospectively in a multicentre study.
  
  
  OBJECTIVE
  This study compared the diagnostic detection rates of EV and HPeV RT-qPCR and viral culture in different specimens (feces, nasopharynx, blood, urine and cerebrospinal fluid (CSF)) of pediatric patients.
  
  
  METHODS
  This prospective, multicenter study performed an EV and HPeV RT-qPCR on nasopharynx, blood, urine, feces and CSF specimens and a viral culture on nasopharynx, feces and CSF specimens in symptomatic children<16 years.
  
  
  RESULTS
  Of 285 included children EV was detected in 140 (49%) and HPeV in 44 (15%) children. Both EV and HPeV RT-qPCR had a higher sensitivity and negative predictive value than EV and HPeV viral culture, respectively. EV and HPeV RT-qPCR in feces specimen had the highest sensitivity (99.2% and 95.1%) of all specimens. Pooling results of specimens increased the detection rate for both viruses.
  
  
  CONCLUSIONS
  Of all specimens, RT-qPCR in feces had the highest detection rate for both EV and HPeV in symptomatic pediatric patients. An EV was detected in all EV positive patients if a RT-qPCR was performed on both feces and CSF specimens or in both feces and urine specimens. HPeV was detected in all HPeV positive patients if a RT-qPCR was performed on both feces and CSF specimens, feces and nasopharynx specimens or CSF and nasopharynx specimens.
authors: Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands. Electronic address: stephanie_de_crom@hotmail.com.
authors: S C M
authors: SC
authors: de Crom
authors: C C
authors: CC
authors: Obihara
authors: R A
authors: RA
authors: de Moor
authors: E J M
authors: EJ
authors: Veldkamp
authors: A M
authors: AM
authors: van Furth
authors: J W A
authors: JW
authors: Rossen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004770:Enterovirus / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D030061:Parechovirus / Q000302:isolation & purification*; D010850:Picornaviridae Infections / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D020133:Reverse Transcriptase Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D014776:Virus Cultivation / Q000379:methods
keywords: CSF; EV; Enterovirus; HEp-2; HPeV; Human parechovirus; NPV; PPV; Pediatric; RNA; RT-qPCR; Viral culture; cerebrospinal fluid; cynomolgus monkey kidney; human epidermoid cancer; human non-polio enterovirus; human parechovirus; negative predictive value; positive predictive value; reverse-transcriptase real time quantitative polymerase chain reaction; ribonucleic acid; tMK