EVALUATION OF A COMMERCIALLY AVAILABLE REVERSE TRANSCRIPTION PCR ASSAY FOR DIAGNOSIS OF ENTEROVIRAL INFECTION IN ARCHIVAL AND PROSPECTIVELYCOLLECTED CEREBROSPINAL-FLUID SPECIMENS

A commercially available reverse transcription (RT)-PCR method (AMPLIC OR EV; Roche Diagnostic Systems, Inc., Branchburg, N.J.) was evaluated for detection of enteroviruses in cerebrospinal fluid from patients w ith neurological disease. This assay was compared with virus isolation in cell culture and an in-house RT-PCR method designed with a nonover lapping region of the enteroviral genome. A panel of 200 cerebrospinal fluid specimens prospectively collected from patients with a wide var iety of neurological symptoms, including 50 patients involved in three different outbreaks of acute aseptic meningitis, was assayed. A secon d panel of 97 archived cerebrospinal fluid specimens, stored for 2 to 5 years, from patients with aseptic meningitis associated with several enterovirus outbreaks was also studied. From the first panel, enterov iruses were detected in 13 of 50 specimens by cell culture (26%), in 4 3 of 50 specimens by AMPLICOR EV (86%), and in 46 of 50 specimens by t he in-house assay (92%) from patients with aseptic meningitis associat ed with outbreak and 1 of 29, 3 of 29, and 4 of 29 specimens, respecti vely, from sporadic cases of aseptic meningitis. The remaining 121 cer ebrospinal fluid specimens from patients with other neurological syndr omes were negative by all tests. From the second panel, enteroviral RN A was detected by the AMPLICOR test (31 of 97 specimens, 32%) and the in-house assay (39 of 97 specimens, 40%). According to our results, pa tients with aseptic meningitis should be analyzed for enteroviral infe ction in cerebrospinal fluid by RT-PCR methods, and the AMPLICOR EV te st is a suitable tool for performing such studies. Archival cerebrospi nal fluid specimens are less suitable for evaluation of the performanc e of RT-PCR methods designed for enterovirus detection.