DETECTION BY PCR OF ENTEROVIRUSES IN CEREBROSPINAL-FLUID DURING A SUMMER OUTBREAK OF ASEPTIC-MENINGITIS IN SWITZERLAND

Enteroviruses (EV) are among the most common causes of aseptic meningi tis, Standard diagnostic techniques are often too slow and lack sensit ivity to be of clinical relevance, EV RNA can be detected within 5 h b y a commercially available reverse transcription-PCR (PZT-PCR) lest ki t, Cerebrospinal fluid (CSF) samples from 68 patients presenting with aseptic meningitis during a summer outbreak in Switzerland were examin ed in parallel with cell culture and commercial RT-PCR, RT-PCR was pos itive in all 16 CSF specimens positive by cell culture (100%). In addi tion, 42 of 52 (80%) CSF samples negative by cell culture were PCR pos itive. In 26 of these 42 (62%) patients, viral culture from other site s (throat swab or stool) was also positive. The CSF virus culture took 3 to 7 days to become positive. Echovirus 30 mas the type most often isolated in this outbreak. The sensitivity of CSF RT-PCR based on clin ical diagnosis during this aseptic meningitis outbreak in patients wit h negative bacterial culture results was 85%, i.e., considerably highe r than the sensitivity of CSF virus culture (24%). We conclude that th is commercial RT-PCR assay allows a positive diagnosis with minimal de lay and may thus influence clinical decisions.