Clinics and Departments

Laboratory Services

Lab Dept:

Microbiology/Virology

Test Name:

ENTEROVIRUS RNA DETECTION PCR, SPINAL FLUID

General Information

Lab Order Codes:

ENTP

Synonyms:

Enterovirus RT PCR; PCR for Enterovirus; Coxsackievirus; Echovirus; Hand, Foot and Mouth Disease

CPT Codes:

87498 – Enterovirus, amplified probe technique

Test Includes:

Detection of enterovirus by Real-Time Polymerase Chain Reaction (PCR)/RNA Probe Hybridization

Logistics

Lab Testing Sections:

Microbiology/Virology Sendouts

Referred to:

Mayo Medical Laboratories (MML: LENT/80066)

Phone Numbers:

MIN Lab: 612-813-6280

STP Lab: 651-220-6550

Test Availability:

Daily

Turnaround Time:

1 - 3 days

Special Instructions:

Requisition must state specific site of specimen and date/time of collection.

Specimen

Specimen Type:

CSF

Container:

CSF: Sterile container

Collection:

CSF: 1. Disinfect skin site with 2% tincture of iodine.

2. Insert needle with stylet at L3 – L4, L4 – L5, or L5 –S1 interspace.

3. Upon reaching the subarachnoid space, remove the stylet and collect
1–2 mL of fluid into each of 3 sterile CSF tubes.

4. Deliver to Microbiology immediately.

Special Processing:

Lab staff: Do Not centrifuge. Send specimen (0.5 mL, Min: 0.3 mL CSF) refrigerated in a screw-capped sterile vial. Maintain sterility and forward promptly. The high sensitivity of amplification by PCR requires the specimen be processed in an environment in which contamination of the specimen not likely.

Sample Rejection:

Specimen submitted in a non-sterile or leaking transport container; improperly labeled specimen; insufficient volume; samples exposed to repeated freeze/thaw cycles; prolonged transport time; improper storage conditions. If an unacceptable specimen is received, the physician or nursing station will be notified.

Interpretive

Reference Range:

Negative

Positive results will be reported as enterovirus RNA detected.

Interpretive: This assay is highly sensitive and specific. The assay detects >10 genomic equivalents of the following viruses:
Coxsackie A – 2, 3, 5, 7, 10, 12, 13, 14, 15, 17, 18, 19, 22
Coxsackie B – 1, 2, 3, 4, 6
Polio – 1, 2, 3
Echovirus 1 through 9, 11 through 22, 24, 25, 26, 27, 29, 30, 32, 33, 71
A positive result indicates the presence of enterovirus in the specimen.

Significant Finding:

Positive: All positive results will be called to the physician or nursing unit.

Limitations:

A negative result does not rule out the possibility of enterovirus infection in the CNS.

This assay may detect virus from a variety of specimen types in asymptomatic individuals. This assay should only be used for patients with a clinical history and symptoms consistent with enterovirus infection, and must be interpreted in the context of the clinical picture. This test should not be used to screen asymptomatic patients.

This is a qualitative assay and results are reported as either negative or positive for targeted enterovirus RNA.

Methodology:

LightCycler PCR has been optimize to detect common conserved sequences in the 5” nontranslated region (NTR) consisting of 711 to 822 nucleotides of enterovirus genotypes.

Additional Information:

  • Proper handling and storage is very important to prevent the destruction of the target RNA by RNases that can be introduced by human hands. Gloving is recommended when handling these specimens. Storage at -70 C also helps stabilize the nucleic acid.
  • The enterovirus group includes the polioviruses, echoviruses, coxsackievirus A and coxsackievirus B.
  • During the summer and the fall, enteroviruses account for over half of the cases involving infants seen in the emergency room presenting with a fever and no other symptoms. More than 90% of community-acquired cases of viral meningitis are caused by coxsackievirus serotypes B2 and B5, and echoviruses 4,6,9,11,16, and 30.

References:

Mayo Medical Laboratories January 2013



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