Introduction of a novel parechovirus RT-PCR clinical test in a regional medical center

Abstract

Background Although data documenting the severity and frequency of human parechovirus (HPeV) infections have been published, detection of HPeV is not routinely performed in most clinical virology laboratories. Objective To describe diagnostic yield, epidemiology and clinical characteristics of patients infected with HPeV during the first year using a new HPeV reverse transcription (RT)-PCR. Study design We introduced an HPeV RT-PCR for the routine testing of cerebrospinal fluid (CSF) and blood samples submitted to our clinical laboratory for detection of human enteroviruses (HEV). Prospective testing of samples with retrospective analysis of medical charts was performed. Results Of the 499 clinical samples received between May, 2009 and May, 2010, 9.6% (46 patients) had HEV detected and 3.4% (15 patients) had HPeV detected. All patients infected by HPeV were <3 months old, hospitalized between June and October 2009, and all typed viruses were HPeV3. Clinical characteristics of HPeV and HEV infected infants were similar. However, patients infected with HPeV were more likely to have a normal leukocyte count in their CSF ( p < 0.001). One HPeV3-infected infant developed encephalitis and another developed hepatitis. Conclusion In our institution, the HPeV RT-PCR was useful to diagnose a novel pathogen in infants with sepsis-like disease.