Key result
Enterovirus RNA was detected in 4.5% of CSF samples from patients with suspected CNS or systemic infections, with 92.3% of positive cases occurring in children under 15 years of age.
Why the study?
Enteroviruses can cause mild to severe diseases, such as central nervous system and systemic infections, but their contribution to acute infections requiring hospitalization needed assessment.
Observational (n=582)
Yes
Enterovirus infections are a notable cause of acute CNS and systemic infections requiring hospitalization, particularly in children under 1 year of age, highlighting the need for laboratory-based surveillance.
EV detection in CSF prioritizes testing in febrile infants; leaves open need for prospective surveillance studies.
BACKGROUND: Enteroviruses (EVs) can cause infections and outbreaks of mild to severe diseases, such as central nervous system (CNS) and systemic infections. The contribution of EVs to acute CNS/systemic infections requiring hospitalization was assessed by analysing data extracted from virology laboratory database. METHODS: Real-life data obtained from two molecular virology laboratories located in Northern Italy were retrieved from databases and analysed retrospectively. The queries used to extract the data were (i) requests for EV-RNA detection in clear cerebrospinal fluid (CSF) specimens collected from hospitalized patients with suspected acute CNS (including aseptic meningitis, encephalitis, and acute flaccid myelitis/paralysis) or systemic infections (sepsis-like illness or fever (≥ 38°C) of unknown origin), (ii) CSF samples collected from January 1st, 2015, to December 31st, 2017. RESULTS: 582 requests of EV-RNA detection in CSF samples collected from as many patients of any age were recorded. EV-RNA was detected in 4.5% of the CSF samples; 92.3% of EV-positive cases were patients < 15 years, 58.3% of whom were < 3 months. EVs circulated all-year-round, and the highest EV-positive rates were observed from May to August. The risk of EV infection and the relative illness ratio value among children < 1 - year - old were significantly higher than those observed for older patients. CONCLUSIONS: EV surveillance should be carried out for all pediatric patients < 15 years and especially children less than 1 year of age with clinically suspected CNS infection/systemic infections. The implementation of a laboratory-based surveillance established for analysing the virological data provided by laboratories that routinely perform EV molecular testing may enable us to determine the impact of EVs that can cause infections requiring hospitalization.
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Piralla et al. (2020) conducted an observational in Suspected acute CNS or systemic infections (n=582). Enterovirus (EV) infection vs. Older patients was evaluated on EV-RNA detection in CSF samples. Enterovirus RNA was detected in 4.5% of CSF samples from patients with suspected CNS or systemic infections, with 92.3% of positive cases occurring in children under 15 years of age.
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