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Detection and Genogrouping of Noroviruses from Children's Stools By Taqman One-step RT-PCR
15:16

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Pitfalls in the diagnosis of enteroviral infection in young children

Howard Faden1, Pravin H Patel, Linda Campagna

  • 1Department of Pediatrics, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Division of Infectious Diseases, Women and Children's Hospital of Buffalo, Buffalo, NY 14222, USA. hfaden@upa.chob.edu

The Pediatric Infectious Disease Journal
|July 29, 2006
PubMed
Abstract

Insights

Enteroviral infection testing in neonatal intensive care units (NICUs) using stool cultures often yields false positives due to stool toxicity and Clostridia difficile. Proper laboratory procedures are crucial for accurate enterovirus detection in infants.

Area of Science:

  • Neonatal infectious diseases
  • Virology
  • Clinical diagnostics

Background:

  • Enteroviral infections pose a risk in neonatal intensive care units (NICUs).
  • An investigation was triggered by three infant enteroviral infections, identifying 31 additional potentially infected infants.
  • A high rate of false-positive results (30 out of 31) complicated the initial findings.

Purpose of the Study:

  • To investigate the causes of false-positive enterovirus results in infants.
  • To identify specific issues within diagnostic laboratory procedures for enterovirus detection.

Main Methods:

  • Retrospective observational study design.
  • Laboratory investigations focused on diagnostic procedure analysis.
  • Stool cultures were utilized as a primary diagnostic method.

Main Results:

  • Several procedural flaws were identified in enterovirus identification.
  • Issues included improper stool specimen filtration and insufficient cell types for tissue culture.
  • Nonspecific stool toxicity, Clostridia difficile toxin presence, and inadequate blocking of fluorescent staining led to misidentification.

Conclusions:

  • Stool culture for asymptomatic enteroviral infections in NICU infants is unreliable.
  • High prevalence of Clostridia difficile toxin and stool toxicity significantly impacts tissue culture results.
  • Implementing standardized and correct laboratory procedures can resolve these diagnostic challenges.

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