Evaluation of enterovirus serological tests IgM-EIA and complement fixation in patients with meningitis, confirmed by detection of enteroviral RNA by RT-PCR in cerebrospinal fluid

Abstract

An enzyme immunoassay (EIA) for detection of anti-enterovirus IgM antibodies was compared with complement fixation test in 43 patients with confirmed enterovirus meningitis by RT-PCR of cerebrospinal fluids (CSF). In 34% of patients with enterovirus meningitis, IgM antibodies could be found, whereas complement fixation tests were positive in only 20%. The specificity was determined with sera of 105 patients with non-enterovirus meningitis. Specificity of IgM EIA and of complement fixation was 94% and 85%, respectively. In four patients with meningitis but without enterovirus detection in CSF, RT-PCR and virus isolation from stools were positive. In three of these patients, IgM antibodies were detected, giving a strong indication of an enterovirus-associated disease. Because of the high specificity of IgM EIA, diagnosis of enterovirus-associated diseases can be carried out in a single serum sample, whereas by complement fixation tests, only fourfold increases in antibody titres in paired sera indicate an acute infection. The application of IgM EIA is especially important in cases of meningitis when CSF samples are not available and for diagnosis of enterovirus diseases with other clinical symptoms such as fever, enteritis, and hand-foot-and-mouth disease.

Frequency of enterovirus detection in blood samples of neonates admitted to hospital with sepsis‐like illness in Kuwait

“…HE775519–HE775531. Virus culture was performed using Vero or HeLa cells in 96‐well tissue culture plates and serotyping for some selected patients (due to limited availability of serum samples from some neonates) was done by virus neutralization test using specific CBVs and patient's serum samples [Terletskaia‐Ladwig et al, ]. The virus was considered to be neutralized when no cytopathic effect was observed after 48 hr of incubation in wells containing type‐specific serum.…”

“…Two sets of controls were also run in parallel. One set was inoculated with virus only and no anti‐serum was added as a control for observing cytopathic effect while the second control was inoculated with anti‐serum only to check for toxicity [Terletskaia‐Ladwig et al, ].…”

Using Real Time PCR For The Etiological Diagnosis Of Viral Encephalitis

“…This method, known as PCR, has allowed the detection of hard to culture pathogens for traditional microbiological laboratories [13][14][15][16][17]. Even though this technique just exposes the presence of genetic material of the procured microorganism (this not implying evidence of the presence of a viable organism), PCR has been demonstrated to be quite useful when is together with an appropriate clinical approach.…”

Rationale und rationelle Enterovirus-Diagnostik

“…Enzymimmuntests zum Antikörpernachweis sind einfach in der Durchführung, sensitiver als die Komplementbindungsreaktion (KBR) und weniger arbeitsintensiv als Neutralisationstests. Es konnte gezeigt werden, dass die Bestimmung Enterovirus-spezifischer IgM-Antikörper die schnelle Bestätigung einer akuten Enterovirus-Infektion in einem Einzelserum erlaubt (13). Die Bestimmung der IgG-Antikörper kann ausschließlich bei Verwendung von Serumpaaren (einem Akutserum und einem Rekonvaleszentenserum) durch eine quantitative Antikörpertiterbestimmung für die Diagnose einer Enterovirus-bedingten Erkrankung herangezogen werden.…”