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RT-PCR based analysis of cell culture negative stools samples from poliomyelitis suspected cases

Ana P Santos1, Eliane V Costa, Silas S Oliveira

  • 1Laboratório de Enterovirus, Instituto Oswaldo Cruz, Rio de Janeiro, Brazil.

Abstract

Insights

Routine diagnosis of acute flaccid paralysis (AFP) often misses enteroviruses. Reverse transcription-polymerase chain reaction (RT-PCR) detected enterovirus RNA in 15% of samples previously negative by cell culture, improving diagnostic sensitivity.

Area of Science:

  • Virology
  • Molecular Biology
  • Infectious Diseases

Background:

  • Classical virological procedures are standard for diagnosing acute flaccid paralysis (AFP).
  • Certain enterovirus serotypes causing neurological disorders are difficult to isolate using conventional cell culture methods.

Purpose of the Study:

  • To investigate the presence of enterovirus genomes in fecal samples that tested negative via cell culture.
  • To evaluate the utility of reverse transcription-polymerase chain reaction (RT-PCR) for detecting enteroviruses in AFP cases.

Main Methods:

  • 173 fecal samples from AFP cases and contacts in Brazil, Peru, and Bolivia were analyzed.
  • Samples initially tested negative for viral isolation in RD and Hep2C cell lines.
  • RT-PCR was performed using primers specific for enterovirus genome RNA.

Main Results:

  • Enterovirus RNA was detected in 26 samples (15%) using RT-PCR.
  • Nucleotide sequencing confirmed the identity of the amplified enterovirus sequences.
  • RT-PCR identified enterovirus RNA in 26 additional samples missed by standard cell culture, demonstrating increased sensitivity.

Conclusions:

  • RT-PCR significantly enhances the detection of enteroviruses in fecal samples from AFP cases.
  • This molecular method improves diagnostic yield for enterovirus infections compared to traditional cell culture.
  • No polioviruses were identified in the enterovirus-positive samples detected by RT-PCR.

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