Multi-assay investigation of viral etiology in pediatric central nervous system infections

  • Aylin Altay-Kocak Department of Medical Microbiology, Faculty of Medicine, Baskent University, Ankara, Turkey
  • Gulendam Bozdayi Department of Medical Microbiology, Faculty of Medicine, Gazi University, Ankara, Turkey
  • Janine Michel Center for Biological Threats and Special Pathogens 1 (ZBS-1), Robert Koch Institute, Berlin, Germany
  • Meltem Polat Paediatric Infections Unit, Department of Paediatric, Faculty of Medicine, Gazi University, Ankara, Turkey
  • Saliha Kanik-Yuksek Department of Paediatric, Ministry of Health Diskapi Yildirim Beyazit Training and Education Hospital, Ankara, Turkey
  • Hasan Tezer Paediatric Infections Unit, Department of Paediatric, Faculty of Medicine, Gazi University, Ankara,
  • Aykut Ozkul Department of Virology, Faculty of Veterinary, Ankara University, Ankara, Turkey
  • Kamruddin Ahmed Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia
  • Andreas Nitsche Center for Biological Threats and Special Pathogens 1 (ZBS-1), Robert Koch Institute, Berlin, Germany
  • Koray Ergunay Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
Keywords: Encephalitis, meningoencephalitis, viral, enterovirus, herpesvirus

Abstract

Introduction: In an attempt to identify a wide spectrum of viral infections, cerebrospinal fluid (CSF) specimens were collected from pediatric cases with the preliminary diagnosis of viral encephalitis/meningoencephalitis in two reference hospitals, from October 2011 to December 2015.

Methodology: A combination of nucleic acid-based assays, including in house generic polymerase chain reaction (PCR) assays for enteroviruses, flaviviruses and phleboviruses, a commercial real-time PCR assay for herpesviruses and a commercial real time multiplex PCR, enabling detection of frequently-observed viral, bacterial and fungal agents were employed for screening.

Results: The microbial agent could be characterized in 10 (10%) of the 100 specimens. Viral etiology could be demonstrated in 7 (70%) specimens, which comprises Human Herpesvirus 6 (4/7), Herpes Simplex virus type1 (2/7) and Enteroviruses (1/7). In 3 specimens (30%), Streptococcus pneumoniae, Listeria monocytogenes and Staphylococcus aureus were detected via the multiplex PCR, which were also isolated in bacteriological media. All specimens with detectable viral nucleic acids, as well as unreactive specimens via nucleic acid testing remained negative in bacteriological cultures.

Conclusions: Herpes and enteroviruses were identified as the primary causative agents of central nervous system infections in children. Enterovirus testing must be included in the diagnostic work-up of relevant cases.

Published
2020-06-30
How to Cite
1.
Altay-Kocak A, Bozdayi G, Michel J, Polat M, Kanik-Yuksek S, Tezer H, Ozkul A, Ahmed K, Nitsche A, Ergunay K (2020) Multi-assay investigation of viral etiology in pediatric central nervous system infections. J Infect Dev Ctries 14:572-579. doi: 10.3855/jidc.12327
Section
Original Articles