AP-HP, Necker Enfants Malades Hospital, Virology department, EA 7328 PACT, Institut Imagine, Université de Paris, Paris, F-75015, France.
CHU Clermont-Ferrand, 3IHP, Virology Department, National Reference Laboratory for Enterovirus and Parechovirus, Clermont Auvergne University, CNRS, LMGE, Clermont-Ferrand, France.
J Clin Virol. 2022 Jun;150-151:105154. doi: 10.1016/j.jcv.2022.105154. Epub 2022 Apr 4.
Enteroviruses (EV) are the most frequent cause of acute meningitis worldwide, and regularly responsible for outbreaks. Human parechoviruses (PeV) are associated with sepsis and meningitis in young infants. In Mayotte, a French department located in the Comoros archipelago, EVs and PeVs are not part of the routine screening of cerebrospinal fluids (CSFs) of patients with meningitis. Consequently, no data is available on EV or PeV epidemiology.
Assess the need for EV and PeV diagnosis in Mayotte.
CSFs collected between March and June 2019 from patients addressed to Mayotte Hospital were retrospectively screened for EV and PeV by PCR. If positive for EV, genotyping was attempted.
EV and PeV RT-PCR were performed on 122/263 (46%) CSFs (45 adults, 77 children). EV meningitis was diagnosed in 16/77 children (21%) with a median age of 32 days (8-62). One 30-days-aged infant presented with a PeV infection. Fever was reported in 94% cases (16/17), followed by gastrointestinal disorders in 29% cases (5/17). EV genotyping achieved identification for 10/16 (63%) EV-positive samples. Four different EV types were identified: Echovirus 16 (E-16, n = 6), EV-B100 (n = 2), and E-14 and E-18 (n = 1, each).
EV/PeV prevalence of 14% highlights the importance of implementing this diagnosis which can impact duration of hospitalization and administration of antibiotics thus reducing risk of antimicrobial resistance. Surveillance of circulating EV types is needed to understand the range of enteroviruses detected in meningitis cases in places that have been underrepresented in enterovirus surveillance studies.
肠道病毒（EV）是全世界引起急性脑膜炎的最常见原因，也是经常引发爆发的原因。人类肠道病毒（PeV）与婴幼儿败血症和脑膜炎有关。在法属马约特岛，EV 和 PeV 并未纳入脑膜炎患者脑脊液（CSF）常规筛查项目。因此，关于 EV 或 PeV 的流行病学数据尚不清楚。
评估在马约特岛进行 EV 和 PeV 诊断的必要性。
2019 年 3 月至 6 月期间，从马约特岛医院就诊的患者中收集 CSF，通过 PCR 对 EV 和 PeV 进行回顾性筛查。如果 EV 呈阳性，则尝试进行基因分型。
对 263 份 CSF 中的 122 份（46%）进行了 EV 和 PeV RT-PCR（45 例成人，77 例儿童）。在 77 名儿童中诊断出 EV 脑膜炎 16 例（21%），中位年龄为 32 天（8-62 天）。一名 30 天大的婴儿感染了 PeV。94%（16/17）的病例有发热，29%（5/17）的病例有胃肠道疾病。对 16 例 EV 阳性样本中的 10 例（63%）进行了 EV 基因分型鉴定。鉴定出 4 种不同的 EV 类型：Echovirus 16（E-16，n=6）、EV-B100（n=2）和 E-14 和 E-18（n=1，各 1 例）。
EV/PeV 的流行率为 14%，这突出了开展该诊断的重要性，这可能会影响住院时间和抗生素的使用，从而降低抗生素耐药的风险。需要监测循环 EV 型，以了解在那些在肠道病毒监测研究中代表性不足的地方检测到的肠道病毒的范围。
