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Journal of Clinical Microbiology, August 2001, p. 2755-2759, Vol. 39, No. 8
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.8.2755-2759.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Detection of Precytopathic Effect of Enteroviruses in Clinical Specimens by Centrifugation-Enhanced Antigen Detection

Steven M. Lipson,1,2,3,* Kathryn David,2 Fatima Shaikh,1,2,*,dagger and Lian Qian2

Department of Biomedical Sciences, Long Island University, Brookville,1 Department of Laboratories, North Shore University Hospital-NYU School of Medicine, Manhasset,2 and Department of Pathology, University Hospital and Medical Center, State University of New York at Stony Brook, Stony Brook,3 New York

Received 20 September 2000/Returned for modification 19 October 2000/Accepted 21 March 2001

Rapid enterovirus detection is important for decisions about antibiotic administration and length of hospital stay. The efficacy of rapid antigen detection-cell culture amplification (Ag-CCA) was evaluated with monoclonal antibodies (MAbs) 5-D8/1 (DAKO) and Pan-Enterovirus clone 2E11 (Chemicon) with 10 poliovirus, echovirus, and coxsackievirus type A and B stock isolates and College of American Pathologists check samples. By using Ag-CCA technology, MAb 2E11 was more sensitive than 5-D8/1 at detecting a greater number of stock isolates at or past tube (cytopathic effect [CPE]) culture (TC) end points. The efficacy of Ag-CCA in the clinical setting was subsequently confirmed with 273 consecutively freshly collected nasopharyngeal aspirate or swab specimens, rectal swab, and cerebrospinal fluid specimens during the 1999 enterovirus season. All specimens were tested by Ag-CCA in parallel with rhesus monkey kidney (RhMk), MRC-5, and A549 conventional TCs. Approximately 60% of field specimens were additionally tested with Hep-2 and HNK conventional TCs. Sixty-two percent of the clinical specimens tested were Ag-CCA positive after 48 h. Among 51 isolates, the mean time to CPE or culture confirmation was 5.5 days (range, 2 to 18 days). After 48 h, Ag-CCA achieved sensitivity, specificity, and positive and negative predictive values of 62, 100, 100, and 93%, respectively. During the same period, TC-CPE displayed test parameters of 12, 100, 100, and 85%, respectively. After 5 days, the sensitivity and specificity of Ag-CCA increased to 92 and 98%, respectively. Within the same period, isolation attained sensitivity and specificity of 52 and 100%, respectively. Although Ag-CCA displayed slightly reduced sensitivity and reduced specificity compared with conventional cell culture after 14 days, the markedly superior 48-h enterovirus Ag-CCA detection rate supports incorporation of this assay into the routine clinical setting.

* Corresponding author. Mailing address: SV(ASCP), Virology Consultants, Inc., 2364 East 74th St., Brooklyn, NY 11234. Phone: (718) 209-3662. Fax: (718) 209-3662. E-mail: montmor{at}aol.com.

dagger Present address: Department of Microbiology & Immunology, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612-7344.

Journal of Clinical Microbiology, August 2001, p. 2755-2759, Vol. 39, No. 8
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.8.2755-2759.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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Antimicrob. Agents Chemother. Clin. Microbiol. Rev.
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Copyright © 2001 by the American Society for Microbiology. All rights reserved.