Department of Pediatrics, St. Elisabeth Hospital, Tilburg, The Netherlands; Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.
J Clin Virol. 2013 Oct;58(2):449-54. doi: 10.1016/j.jcv.2013.07.017. Epub 2013 Aug 21.
Reverse-transcriptase quantitative real-time polymerase chain reaction (RT-qPCR) has become the gold standard for the diagnosis of human enterovirus (EV) and parechovirus (HPeV) infections. The detection rate of RT-qPCR in different pediatric body specimens has not been compared prospectively in a multicentre study.
This study compared the diagnostic detection rates of EV and HPeV RT-qPCR and viral culture in different specimens (feces, nasopharynx, blood, urine and cerebrospinal fluid (CSF)) of pediatric patients.
This prospective, multicenter study performed an EV and HPeV RT-qPCR on nasopharynx, blood, urine, feces and CSF specimens and a viral culture on nasopharynx, feces and CSF specimens in symptomatic children<16 years.
Of 285 included children EV was detected in 140 (49%) and HPeV in 44 (15%) children. Both EV and HPeV RT-qPCR had a higher sensitivity and negative predictive value than EV and HPeV viral culture, respectively. EV and HPeV RT-qPCR in feces specimen had the highest sensitivity (99.2% and 95.1%) of all specimens. Pooling results of specimens increased the detection rate for both viruses.
Of all specimens, RT-qPCR in feces had the highest detection rate for both EV and HPeV in symptomatic pediatric patients. An EV was detected in all EV positive patients if a RT-qPCR was performed on both feces and CSF specimens or in both feces and urine specimens. HPeV was detected in all HPeV positive patients if a RT-qPCR was performed on both feces and CSF specimens, feces and nasopharynx specimens or CSF and nasopharynx specimens.
逆转录实时定量聚合酶链反应（RT-qPCR）已成为人类肠道病毒（EV）和肠道病毒（HPeV）感染诊断的金标准。在多中心研究中，尚未前瞻性比较不同儿科标本中 RT-qPCR 的检测率。
本研究比较了 EV 和 HPeV RT-qPCR 与病毒培养在儿科患者不同标本（粪便、鼻咽、血液、尿液和脑脊液（CSF））中的诊断检测率。
本前瞻性、多中心研究对鼻咽、血液、尿液、粪便和 CSF 标本进行 EV 和 HPeV RT-qPCR 检测，对有症状的<16 岁儿童的鼻咽、粪便和 CSF 标本进行病毒培养。
在 285 例纳入的儿童中，140 例（49%）检测到 EV，44 例（15%）检测到 HPeV。EV 和 HPeV RT-qPCR 的敏感性和阴性预测值均高于 EV 和 HPeV 病毒培养。粪便标本中 EV 和 HPeV RT-qPCR 的敏感性（99.2%和 95.1%）最高。所有标本的合并结果提高了两种病毒的检测率。
在所有标本中，粪便 RT-qPCR 对有症状的儿科患者的 EV 和 HPeV 具有最高的检测率。如果在粪便和 CSF 标本或粪便和尿液标本中均进行 RT-qPCR 检测，则可在所有 EV 阳性患者中检测到 EV。如果在粪便和 CSF 标本、粪便和鼻咽标本或 CSF 和鼻咽标本中均进行 RT-qPCR 检测，则可在所有 HPeV 阳性患者中检测到 HPeV。
