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September 1996

Prospective Comparison of Culture vs Genome Detection for Diagnosis of Enteroviral Meningitis in Childhood

Author Affiliations

From the Department of Pediatrics, School of Medicine, University of California–San Diego, La Jolla (Drs Tanel, Stucky, and Burns and Mss Holland and Shoaf), and Roche Molecular Systems, Alameda, Calif (Dr Kao and Ms Niemiec), and Somerville, NJ (Dr Loeffelholz). Dr Tanel is now with the Department of Cardiology, Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass.

Arch Pediatr Adolesc Med. 1996;150(9):919-924. doi:10.1001/archpedi.1996.02170340033006

Objective:  To assess the sensitivity and specificity of a new polymerase chain reaction (PCR) assay with uninterrupted reverse transcription and complementary DNA amplification (RT-PCR) for the diagnosis of enteroviral (EV) meningitis in children.

Design:  A prospective, cohort study.

Settings:  Two medical centers: 1 university hospital and 1 children's hospital in San Diego County, California, during a 5-week period.

Patients:  All pediatric patients younger than 16 years who underwent a lumbar puncture for evaluation of possible meningitis.

Main Outcome Measures:  The results of cerebrospinal fluid (CSF) RT-PCR were compared with viral cultures and clinical histories.

Results:  During the 5-week period, 90 patients were entered into the study. Nonpolio EVs were cultured from 10% (9/90) of the patients from the following sites: CSF, 6.7% (6/90) of the patients; stool, 19% (4/21) of the patients; and throat swabs, 5.6% (1/18) of the patients. The EV genome was detected in the CSF by using RT-PCR in 7 of 9 EV culture–positive patients. The sensitivity and specificity of the CSF RT-PCR assay to detect EV meningitis were 77.8% and 100%, respectively. This compared with a sensitivity of 66.7% for detection of EV in CSF by viral culture alone.

Conclusion:  The new RT-PCR assay is a rapid and reliable method for the detection of EV infection in childhood.Arch Pediatr Adolesc Med. 1996;150:919-924