[Diagnostic of neurotropic enteroviruses in children with CSF and/or stool: virus isolation by cell culture or PCR?].

BACKGROUND: Aseptic meningitis in children is most frequently caused by enteroviruses. In clinical setting there arises the question, whether stool samples or cerebrospinal fluid (CSF) are better suited for laboratory diagnosis.
METHODS: Between 06/2006 and 03/2010 a total number of 613 specimens (376 CSF [61.4%] and 237 stool [38.6%]) of 613 children (270 female [44.1%] and 343 [55.9%] male) aged 22 days to 15 years were collected and investigated by enterovirus-PCR and by virus isolation in cell culture, respectively.
RESULTS: Enterovirus was detected in 35.4% (217/613) of the samples by cell culture and/or PCR. In total, specimens of CSF were significantly (p<0.001) more often positive (59.4%, n=129) for enterovirus than stool (40.6%; n=88). Concerning stool, PCR gained no significant advantage when compared to cell culture (35.4% vs. 27.8%; p=0.08), However, virus isolation in cell culture using CSF samples succeeded significantly PCR (30.1% vs. 13.8%; p<0.001). DISCUSSION: Because of its not-invasive sampling, stool is the preferred specimen in suspicion of aseptic meningitis in pediatric clinic. If only stool is available, PCR as well as cell culture are valuable; on contrary, if CSF is available cell culture is significantly superior to PCR in attaining a positive result. © Georg Thieme Verlag KG Stuttgart · New York.