Comparison of cell culture with RT-PCR for enterovirus detection in stool specimens from patients with acute flaccid paralysis.

Since October 2000, Iran has been declared polio-free by the World Health Organization (WHO). Despite the fact that poliomyelitis caused by polioviruses has been eliminated from Iran, the number of acute flaccid paralysis (AFP) cases has not been reduced. Therefore, it is of great importance to investigate the other viral agents that may cause AFP (mainly nonpolio enteroviruses, which play a significant role in the etiology of neurological syndromes). Some enteroviruses do not grow in the conventional cell lines that are being used for enterovirus detection. Furthermore, the virus titer is an important factor in the sensitivity of cell culture to detect the virus. The fact that cell culture is a time-consuming procedure is another reason to find a more practical method for enterovirus detection. Therefore, a more sensitive and rapid method should be used to detect enteroviruses as efficiently as possible in the stool specimens of AFP cases. The aim of this study was to evaluate cell culture and RT-PCR in enterovirus detection. Findings have shown that RT-PCR can increase the rate of nonpolio enterovirus detection by up to 10% in comparison with cell culture. Also, the rapid detection of enteroviruses by RT-PCR can decrease both the unnecessary use of antibiotics and the costs in clinical practice. For this reason, we find that RT-PCR is a more practical technique for enterovirus detection. Copyright (c) 2007 Wiley-Liss, Inc.