LETTER


Impact of Enterovirus Molecular Assay Turnaround Time on Hospitalization Length During an Echovirus 30 Meningitis Outbreak, France, Fall 2014



Yohan N’Guyen1, 2, *, Anne L. Lebreil1, Philippine Simphal2, Christine Pietrement3, Nathalie Bednarek4, Pauline Orquevaux2, Paul A. Gretteau1, Laurent Andreoletti1
1 Laboratoire de Virologie EA 4684. UFR Médecine, Université Reims Champagne Ardennes, 51 rue Cognacq Jay 51100 Reims, France
2 Service de Médecine interne, maladies infectieuses et Immunologie Clinique, Hôpital Robert Debré, Avenue Général Koenig 51100 Reims, France
3 Service de Pédiatrie Générale et spécialisée, American Memorial Hospital, 47 Rue Cognacq-Jay, 51100 Reims, France
4 Service de Médecine Néonatale et Réanimation Pédiatrique, Institut Mère Enfant Alix de Champagne, 45 Rue Cognacq-Jay, 51100 Reims, France


© 2019 N’Guyen et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to these authors at the Avenue Général Koenig, 51100 Reims, France; Tel: (+33)326789422; Fax: (+33)326784090;
Email: yohan.nguyen@wanadoo.fr


Abstract

Background:

The impact of Enterovirus Real Time-Polymerase Chain Reaction assay (EV RT-PCR) on hospitalization lengths of patients with aseptic meningitis has been investigated but the impact of early EV RT-PCR results released on time before patient discharge remains unclear during Echovirus meningitis outbreaks.

Objective:

To assess a potential correlation between EV RT-PCR turn-around time and hospitalization lengths during an Echovirus meningitis outbreak.

Method:

Eighteen patients demonstrating a positive EV RT-PCR assay performed on Cerebrospinal Fluid (CSF) samples collected between October 1st 2014 and December 31st 2014 were retrospectively included. Viral protein 1 (VP1) gene region was amplified and sequenced using a classical Sanger sequencing reaction. Clinical data were retrospectively collected from patient’s records. Quantitative variables expressed as median values and ranges were compared using Mann Whitney U test. Correlations were performed using simple regression analysis.

Results:

Phylogenetic VP1 sequence analyses identified that the outbreak was related to an Echovirus 30 strain in 7 out of the 10 cases with available sequencing data. The three remaining sequences analyses evidenced Echovirus 14, 9 and 7 strains. Hospitalization length was statistically shorter in children without comorbidity (n=5) than in adult patients (n=10) or neonates and children with comorbidity (n=3) (p=0.003 and 0.01 respectively), whereas EV RT-PCR turnaround time was not statistically different between these groups. Correlation between hospitalization length and EV RT-PCR turnaround time was poor (R2=0.06), especially in adults (R2=0.01)

Conclusion:

Our data indicated that EV RT-PCR turnaround time was not correlated to hospitalization length during a short Echovirus meningitis outbreak.

Keywords: Hospitalization length, Enterovirus, Outbreak, Aseptic meningitis, Real-time polymerase chain reaction, Cerebrospinal fluid.