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Journal of Clinical Microbiology, September 1998, p. 2408-2412, Vol. 36, No. 9
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Detection by PCR of Enteroviruses in Cerebrospinal Fluid during a Summer Outbreak of Aseptic Meningitis in Switzerland

Meri Gorgievski-Hrisoho,1,* Jean-Daniel Schumacher,2 Nevenka Vilimonovic,2 Daniel Germann,1 and Lukas Matter1

Institute for Medical Microbiology, University of Bern, Bern,1 and Cantonal Hospital, Fribourg,2 Switzerland

Received 2 February 1998/Returned for modification 10 April 1998/Accepted 8 June 1998

Enteroviruses (EV) are among the most common causes of aseptic meningitis. Standard diagnostic techniques are often too slow and lack sensitivity to be of clinical relevance. EV RNA can be detected within 5 h by a commercially available reverse transcription-PCR (RT-PCR) test kit. Cerebrospinal fluid (CSF) samples from 68 patients presenting with aseptic meningitis during a summer outbreak in Switzerland were examined in parallel with cell culture and commercial RT-PCR. RT-PCR was positive in all 16 CSF specimens positive by cell culture (100%). In addition, 42 of 52 (80%) CSF samples negative by cell culture were PCR positive. In 26 of these 42 (62%) patients, viral culture from other sites (throat swab or stool) was also positive. The CSF virus culture took 3 to 7 days to become positive. Echovirus 30 was the type most often isolated in this outbreak. The sensitivity of CSF RT-PCR based on clinical diagnosis during this aseptic meningitis outbreak in patients with negative bacterial culture results was 85%, i.e., considerably higher than the sensitivity of CSF virus culture (24%). We conclude that this commercial RT-PCR assay allows a positive diagnosis with minimal delay and may thus influence clinical decisions.

* Corresponding author. Mailing address: Institute for Medical Microbiology, University of Bern, Friedbühlstrasse 51, CH-3010 Bern, Switzerland. Phone: 41 31 632 3562. Fax: 41 31 632 4966. E-mail: gorgievski{at}imm.unibe.ch.

Journal of Clinical Microbiology, September 1998, p. 2408-2412, Vol. 36, No. 9
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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Antimicrob. Agents Chemother. Clin. Microbiol. Rev.
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Copyright © 1998 by the American Society for Microbiology. All rights reserved.