ABSTRACT
BACKGROUND: Enteroviruses (EVs) are the leading cause of aseptic meningitis worldwide. Detection of enteroviral RNA in clinical specimens has been demonstrated to improve the management of patient care, especially that of neonates and young children. FINDINGS: To establish a sensitive and reliable assay for routine laboratory diagnosis, we compared the sensitivity and specificity of the GeneXpert Enterovirus Assay (GXEA) with that of the reverse transcription polymerase chain reaction (RT-PCR) based assay referred to as real-time one step RT-PCR (RTo-PCR). The sensitivity/specificity produced by GXEA and RTo-PCR were 100%/100% and 65%/100%, respectively. CONCLUSIONS: Both methods evaluated in this article can be used for detection of enterovirus in clinical specimens and these nucleic acid amplification methods are useful assays for the diagnosis of enteroviral infection.
Subject(s)
Enterovirus Infections/virology , Enterovirus/isolation & purification , Meningitis/virology , RNA, Viral/genetics , Real-Time Polymerase Chain Reaction/methods , Reverse Transcriptase Polymerase Chain Reaction/methods , Enterovirus/genetics , Enterovirus Infections/cerebrospinal fluid , Enterovirus Infections/diagnosis , Humans , Meningitis/cerebrospinal fluid , Meningitis/diagnosis , Molecular Diagnostic Techniques , RNA, Viral/cerebrospinal fluidABSTRACT
BACKGROUND: Enterovirus (EV) infections are commonly associated with encephalitis and meningitis. Detection of enteroviral RNA in clinical specimens has been demonstrated to improve the management of patients, by ruling out other causes of disease. METHOD: To develop a sensitive and reliable assay for routine laboratory diagnosis, we developed a real-time one step reverse transcription polymerase chain reaction (RT-PCR) assay with minor groove binder probes and primers modified with complementary locked primer technology (TMC-PCR). We checked the sensitivity of the developed assay by comparing it to a previously published TaqMan probe real-time one-step RT-PCR (TTN-PCR) procedure using enteroviral isolates, Enterovirus Proficiency panels from Quality Control on Molecular Diagnostics (QCMD-2007), and clinical specimens from patients with suspected EV infections. RESULTS: One hundred clinical specimens from 158 suspected viral meningitis cases were determined to be positive by the TMC-PCR assay (63.29%), whereas only 60 were found to be positive by the TTN-PCR assay (37.97%). The positive and negative agreements between the TMC-PCR and TTN-PCR assays were 100% and 59.2%, respectively. CONCLUSION: This data suggest that the TMC-PCR assay may be suitable for routine diagnostic screening from patient suspected EV infection.
Subject(s)
DNA Primers/genetics , Enterovirus Infections/diagnosis , Enterovirus/genetics , Enterovirus/isolation & purification , RNA, Viral/genetics , Reverse Transcriptase Polymerase Chain Reaction/methods , Virology/methods , Enterovirus/classification , Enterovirus Infections/virology , Humans , Sensitivity and SpecificityABSTRACT
To increase detection sensitivity, we modified primers using complementary locked primer (CLP) technology. The sensitivity of the reverse transcription-PCR (RT-PCR) with CLP-modified primers was 10- to 100-fold higher than that of RT-PCR without these primers. CLP-modified primers can increase sensitivity, providing a widely accessible method for molecular diagnosis.
