Hosoya Mitsuaki, Sato Masatoki, Honzumi Ken, Katayose Masahiko, Sakuma Hiroko, Ishiko Hiroaki, Shimada Yasushi, Kato Kazuo, Suzuki Hitoshi
Department of Paediatrics, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukusima 960-1295, Japan.
J Clin Virol. 2002 Jul;25 Suppl 1:S27-38. doi: 10.1016/s1386-6532(02)00031-8.
Enteroviral infections of the central nervous system (CNS) are often difficult to diagnose, even if consistent conventional laboratory methodologies are used.
To clarify the efficiency of two polymerase chain reaction (PCR) methods for the sensitive detection of enteroviruses and for the identification of enteroviral genotypes based on phylogenetic analysis of the amplified genome sequences, and to facilitate the diagnosis of enteroviral infection in CNS.
Cerebrospinal fluid (CSF), throat swab, rectal swab, and/or serum samples were collected from 171 patients with aseptic meningitis and 67 patients with febrile seizures. The samples were tested for the presence of enteroviruses by cell culture and PCR methods for the detection and identification of enteroviruses.
In 111 (64.9%) of 171 patients with aseptic meningitis, enteroviruses were isolated by cell cultures from any site. In 143 (83.6%) patients, including 110 of 111 patients with aseptic meningitis, the enteroviral genome was detected in CSF by PCR. No enterovirus was isolated from any site for the 67 patients with febrile seizures. PCR detected the enteroviral genome in CSF samples from 13 (61.9%) of 21 patients who developed febrile seizures in the summer (June-August). Phylogenetic analysis of amplified genome sequences showed that the major pathogens of febrile seizures in summer were group A coxsackieviruses, which are usually difficult to isolate by cell culture.
PCR methods for the detection and identification of enteroviruses were useful for the diagnosis of enteroviral infection in CNS.
即使使用一致的传统实验室方法，中枢神经系统（CNS）的肠道病毒感染通常也难以诊断。
基于扩增基因组序列的系统发育分析，阐明两种聚合酶链反应（PCR）方法对肠道病毒的灵敏检测及肠道病毒基因型鉴定的效率，以促进中枢神经系统肠道病毒感染的诊断。
从171例无菌性脑膜炎患者和67例热性惊厥患者中采集脑脊液（CSF）、咽拭子、直肠拭子和/或血清样本。通过细胞培养和用于检测及鉴定肠道病毒的PCR方法对样本进行肠道病毒检测。
171例无菌性脑膜炎患者中，111例（64.9%）通过细胞培养从任何部位分离出肠道病毒。143例（83.6%）患者，包括111例无菌性脑膜炎患者中的110例，通过PCR在脑脊液中检测到肠道病毒基因组。67例热性惊厥患者未从任何部位分离出肠道病毒。PCR在夏季（6 - 8月）发生热性惊厥的21例患者中的13例（61.9%）的脑脊液样本中检测到肠道病毒基因组。扩增基因组序列的系统发育分析表明，夏季热性惊厥的主要病原体是A组柯萨奇病毒，通常难以通过细胞培养分离。
用于检测和鉴定肠道病毒的PCR方法对中枢神经系统肠道病毒感染的诊断有用。
