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Enterovirus reverse transcriptase polymerase chain reaction assay in cerebrospinal fluid: an essential tool in

Ana Isabel Menasalvas-Ruiz1, Carme Salvador-García, Antonio Moreno-Docón

  • 1Unidad de Enfermedades Infecciosas-Servicio de Pediatría, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. amenasalvas@hotmail.com

Enfermedades Infecciosas Y Microbiologia Clinica
|December 15, 2012
PubMed
Abstract

Insights

Enterovirus (EV) real-time RT-PCR in cerebrospinal fluid rapidly diagnoses EV meningitis in children, enabling earlier discharges and reducing unnecessary antibiotic use. This test is crucial for managing pediatric aseptic meningitis, especially during outbreaks.

Area of Science:

  • Pediatric Infectious Diseases
  • Virology
  • Molecular Diagnostics

Background:

  • Enteroviruses (EV) are primary causes of aseptic meningitis in children and febrile illnesses in infants.
  • Rapid diagnosis is critical for differentiating EV infections from other conditions.
  • Real-time reverse transcriptase polymerase chain reaction (RT-PCR) in cerebrospinal fluid (CSF) offers a fast diagnostic method.

Purpose of the Study:

  • To describe enterovirus meningitis in children.
  • To evaluate the role of the real-time RT-PCR assay in managing pediatric EV meningitis.
  • To assess the impact of rapid diagnosis on clinical management and treatment decisions.

Main Methods:

  • Retrospective collection of demographic, clinical, and laboratory data from children (≤11 years) with EV RT-PCR positive CSF.
  • Study period: December 2007 to July 2010.
  • Utilized Cepheid® Xpert EV assay for enterovirus detection.

Main Results:

  • 92 children included (mean age 2.5 years), 32% neonates.
  • 18.5% of patients lacked CSF pleocytosis; 25% were discharged home after positive EV RT-PCR results.
  • Shorter hospital stays (2 days vs. 4.5 days for newborns) and reduced inappropriate antibiotic prescriptions (40% stopped) were observed.
  • Mean EV RT-PCR turnaround time was 7 hours.
  • All children achieved good clinical outcomes.

Conclusions:

  • EV RT-PCR assay in CSF is essential for managing pediatric enterovirus meningitis.
  • The assay facilitates earlier patient discharges and reduces unnecessary antibiotic treatments.
  • This diagnostic tool should be part of the initial workup for pediatric aseptic meningitis, particularly during epidemic periods.

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