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Prospective case-control study of enterovirus detection differences in children's cerebrospinal fluid between
Dianping You1, Fang Chen2, Jingjie Li2
1Institute of Pediatric Research, Children's Hospital of Hebei Province, Shijiazhuang, China.
Insights
Multiplex PCR offers superior sensitivity and consistency for detecting enterovirus in pediatric viral encephalitis cases compared to real-time PCR, aiding accurate diagnosis.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Viral encephalitis is a significant cause of acute brain inflammation in children, with enteroviruses being the most common culprits.
- Atypical clinical presentations necessitate reliable pathogenic testing for accurate diagnosis of viral encephalitis.
- Enterovirus detection in cerebrospinal fluid (CSF) is crucial for guiding clinical management.
Purpose of the Study:
- To evaluate the diagnostic performance of a multiplex PCR assay against quantitative real-time PCR for enterovirus detection in pediatric CSF samples.
- To compare the sensitivity, specificity, and clinical consistency of multiplex PCR versus real-time PCR for enterovirus identification.
Main Methods:
- A prospective case-control study involving 103 pediatric patients with suspected viral encephalitis.
- Cerebrospinal fluid (CSF) samples were analyzed using a multiplex PCR assay targeting 9 pathogens and a real-time PCR assay specifically for enterovirus.
- Data collected between April and November 2018.
Main Results:
- Viral encephalitis was confirmed in 85.4% of pediatric patients upon discharge.
- Multiplex PCR demonstrated higher sensitivity and greater consistency with clinical diagnosis compared to real-time PCR.
- Multiplex PCR also identified co-infections, including enterovirus with Epstein-Barr virus and mumps virus.
Conclusions:
- The multiplex PCR assay is a superior method for detecting enterovirus in CSF samples from pediatric patients with suspected viral encephalitis.
- Multiplex PCR results align more closely with clinical diagnoses, improving diagnostic accuracy.
- The ability of multiplex PCR to detect multiple pathogens simultaneously enhances its utility in diagnosing complex cases.
Background:
Viral encephalitis is common in childhood. It is an acute brain parenchymal inflammation caused by a variety of viral infection, and enterovirus accounts for the majority. Due to atypical clinical manifestations, pathogenic testing is important for assisting clinical diagnosis. The purpose of this study was to evaluate the performance of the multiplex PCR assay compared with quantitative real-time PCR for enterovirus detection.
Methods:
A prospective case-control study was performed involving 103 pediatric patients suspected for viral encephalitis and cerebrospinal fluid (CSF) samples were collected and tested for 9 pathogens using multiplex PCR assay during April to November in 2018. In parallel, an aliquot of samples was tested for enterovirus infection by real-time PCR assay.
Results:
There were 85.4% children were confirmed as viral encephalitis on discharge, the remaining ones were diagnosed as other CNS diseases, such as epilepsy. The specificity of the two methods was the same as that of the clinical diagnosis, but the sensitivity and consistency with clinical diagnosis of multiplex PCR were both higher than the real-time PCR. Besides of enterovirus, multiplex PCR could also detect coinfection of enterovirus with Epstein-Barr virus and mumps virus.
Conclusion:
Results of multiplex PCR method are more consistent with the clinical diagnosis and are superior to real-time PCR for detecting enterovirus in CSF.
