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Enteric viruses circulating in undiagnosed central nervous system infections at tertiary hospital in São José do Rio Preto, São Paulo, Brazil
Author(s) -
Rocha Leonardo Cecílio da,
Estofolete Cássia Fernanda,
Milhim Bruno Henrique Gonçalves de Aguiar,
Augusto Marcos Tayar,
Zini Nathalia,
Silva Gislaine Celestino Dutra da,
FerrazJunior Hélio Correa,
Brienze Vânia Maria Sabadoto,
Liso Elisabete,
Cunha Mariana Sequetin,
Sabino Ester Cerdeira,
da Costa Antonio Charlys,
Nogueira Maurício Lacerda,
Luchs Adriana,
Terzian Ana Carolina Bernardes
Publication year - 2021
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.26216
Subject(s) - aseptic meningitis , echovirus , enterovirus , virology , meningitis , astrovirus , biology , virus , coxsackievirus , viral meningitis , genotyping , rotavirus , encephalitis , medicine , genotype , pediatrics , bacterial meningitis , genetics , gene
Abstract Enterovirus (EV) is commonly associated with central nervous system (CNS) syndromes. Recently, gastroenteric viruses, including rotavirus (RVA), human astrovirus (HAstV), and norovirus (NoV), have also been associated with CNS neurological disorders. The aim of the present study was to investigate the presence of EV, RVA, HAst, and NoV associated to CNS infections with undiagnosed etiology in Northwest region of São Paulo State, Brazil, and to conduct the molecular characterization of the positive samples detected. A total of 288 cerebrospinal fluid samples collected from July to December 2017 were tested for EV and NoV by quantitative real‐time polymerase chain reaction (RT‐qPCR), HAstV by conventional RT‐PCR, and RVA by enzyme‐linked immunosorbent assay. Positive‐EV samples were inoculated in cells lines, amplified by RT‐PCR and sequenced. RVA, NoV, and HAstV were not detected. EV infection was detected in 5.5% (16/288), and five samples successful genotyped: echovirus 3 (E3) (1/5), coxsackie virus A6 (CVA6) (1/5), and coxsackie virus B4 (CVB4) (3/5). Meningitis was the main syndrome observed (12/16; 75%). CVA6, CVB4, and E3 were identified associated with aseptic meningitis. Reports of CVA6 associated with aseptic meningitis are rare, E3 had not been previously reported in Brazil, and epidemiological data on CVB4 in the country is virtually unknown. The present investigation illustrates the circulation of diverse EV types in a small regional sample set and in a short period of time, highlighting the importance of an active EV surveillance system in CNS infections. Enhanced understanding of undiagnosed CNS infections will assist in public health and health care planning.