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PubMed1993

A Nordic reference serum suitable for use as trueness control in the clinical routine laboratory.

The described reference serum is characterized by: liquid human serum at "normal" level stored in frozen state at -80 degrees C; minimum damage of proteins; aseptic preparation; cryoprecipitate and excess fibrin removed; serum cleared by ultracentrifugation; pH at 7.2-7.6; available in sealed glass ampoules with inert gas (one ml serum in each); specified components among most frequently analyzed analytes; homogeneity assured and stability monitored; produced under strict rules for good manufacturing practices (GMP). The assigned values are traceable to reference measurement procedures and reference materials of highest achievable metrological level; according to the present proposal the maximum allowable uncertainty of the assigned value is based on biological variation (shared common reference intervals); the uncertainty should ideally not exceed 1/5 of the maximum allowable bias of results obtained on patients samples (even 1/2 would theoretically be acceptable and, for a practical guide approximately < 1% may suffice). The present document provides some guidance of how the reference serum could be established in practice. The document also indicates the use of the material and further extension of the concept. The present work is done as a NORDKEM project.

Blood Chemical Analysis↗
PubMedDate not supplied

[Specific clinical, epidemiological patterns and laboratory diagnostics of enterovirus infection in the Republic of Belarus].

The clinical and epidemiological patterns as well as the results of the laboratory verification of the outbreak of enterovirus infection (EVI) in Minsk during the period of summer-autumn, 2000, are presented. During this outbreak a variety of clinical forms were observed, the serous meningitis being prevalent (57.5%). Practically simultaneous occurrence of infection on the territory of all administrative districts of the city, the predominant involvement of children aged up to 14 years into the outbreak, a high proportion of simultaneous casualities in the multiple foci. A number of circulating enteroviruses (EV)--ECHO 30, ECHO 6 of three serotypes and Coxsackie B5--were simultaneously isolated from clinical material. EV of the same serotypes were isolated from tap drinking water, and neutralizing antibodies to these serotypes were often detected in the patients blood sera. Infectious EV were also present in samples of bottled water and in water reservoirs used for bathing. The routes of EV transmission and the improvement of EVI control are discussed.

Adolescent↗
PubMedDate not supplied

[A fatal case of Herpes simplex virus meningoencephalitis in an immunocompetent adult].

Management of herpes simplex virus encephalitis (HSE) has been considerably improved by the development of rapid polymerase chain reaction (PCR) assays and by the use of intravenous acyclovir. However, an absence of early antiviral treatment has been associated to a poor outcome in patients with HSE. In the present report, we described the case of a 53 years-old adult immunompetent patient who was admitted to the emergency department of university medical center of Reims (France). At the time of hospitalisation, he was suffering from a febrile encephalitis syndrome evolving for more than 24 hours. A cerebrospinal fluid (CSF) puncture was performed demonstrating the presence of a lymphocytic meningitidis (42 leukocytes/mm3 which 90% of mononuclear cells; CSF protein = 1650 mg/L) associated with high levels of interferon alpha (75 UI/mL). Specific herpesvirus PCR and hybridisation assays (Herpes Consensus Hybridowell, Argene, France) were positive for the detection of HSV-1 genome on this CSF sample. Despite the intravenous acyclovir treatment (15 mg/kg/8 hours) delivered at the time of hospitalisation, this immunocompetent adult patient will dead 15 days later by a cardiorespiratory failure that was related to extensive HSE lesions. The time delay between the beginning of the clinical syndrome and the instauration of intravenous acyclovir treatment (more than 24 hours) was the only point susceptible to explain the presence of extensive CNS lesions in this patient. Specific Herpesvirus PCR detection assays are powerful tools that are actually used to establish a rapid etiological diagnosis of viral meningo-encephalitis. However, in patients demonstrating clinical signs of encephalitis associated with an aseptic CSF, it remains essential to urgently initiate a presumptive intravenous acyclovir treatment (10-15 mg/kg/8 hours). Actually, this medical practice is the only one susceptible to reduce the morbi-mortality rates linked to HSE.

Encephalitis, Herpes Simplex↗
PubMed1989

Elevated fibrin D-dimer fragment in sickle cell anemia: evidence for activation of coagulation during the steady state as well as in painful crisis.

The fibrin D-dimer degradation fragment is produced by plasmin degradation of cross-linked fibrin. Elevated plasma D-dimer levels indicate increased plasmin degradation of cross-linked fibrin, and are therefore an indirect indication of increased thrombin activity and fibrin formation. With an ELISA assay sensitive to plasma D-dimer levels of less than 50 ng/ml, elevated levels of D-dimer were found in 23 of 25 subjects with sickle cell disease tested during the steady state, and in all 21 subjects tested serially while hospitalized for painful crisis (total of 40 samples). Mean D-dimer was 79 +/- (SD) 25 ng/ml in 35 normal subjects, 566 +/- 739 ng/ml in sickle cell disease subjects in the steady state, and 1,038 +/- 1,010 ng/ml in sickle cell subjects during painful crisis; these differences were highly significant (p less than 0.001). No correlation was observed between levels of D-dimer in the steady state and the time since the last painful crisis; D-dimer was elevated in all 7 patients tested more than 6 months after their last painful crisis. Most steady-state patients did not have other microvascular occlusive manifestations, such as active leg ulcers or aseptic necrosis of bone, which could explain the increased D-dimer levels observed. It is concluded that increased thrombin activity and fibrin formation are features of steady-state sickle cell disease, and that they further increase during painful crisis. Possible causes and implications of increased thrombin activity and fibrin formation in subjects with sickle cell disease are discussed.

Anemia, Sickle Cell↗
PubMed2002

Bacterial contamination of propofol: the effects of temperature and lidocaine.

BACKGROUND AND OBJECTIVE: The intravenous anaesthetic propofol may become contaminated once the ampoules have been opened. The effect of lidocaine and cooling was tested on the bacterial contamination of propofol. METHODS: The study was performed in two parts. In Part 1,1920 aliquots of propofol alone, and of a propofollidocaine mixture, were drawn into sterile syringes and stored at room temperature (24-26 degrees C) or in the refrigerator (12-14 degrees C). In Part 2, 1200 aliquots from opened ampoules of propofol alone, or as a propofol-lidocaine mixture, were stored at room temperature or in the refrigerator. Samples were aerobically cultured at 0, 1, 2, 4, 8 and 12 h. RESULTS: In Part 1, diphtheroid bacillus was isolated from one aliquot (0.06%). In Part 2, there was bacterial growth in both groups; the number of contaminated ampoules increased with time and it was 20-26% at 12 h. Diphtheroid bacilli and coagulase-negative staphylococci were the most frequent micro-organisms. CONCLUSIONS: When propofol is stored in opened ampoules, the bacterial contamination rate is high. Adding lidocaine, or storing opened ampoules at 12-14 degrees C, does not affect the contamination rate, except during the first few hours. It is advisable to draw propofol aseptically into a syringe in an amount that can be used during one procedure.

Anesthetics, Intravenous↗
PubMed2003

Premixed solutions of diamorphine in ropivacaine for epidural anaesthesia: a study on their long-term stability.

BACKGROUND: Local anaesthetics and opioid mixtures are commonly used to provide anaesthesia or analgesia during the perioperative period. In order to facilitate their preparation and storage it is necessary to establish the stability of such solutions. METHODS: In our study, diamorphine was added to ropivacaine 0.2% 200-ml polybags to give a concentration of 25 micro g ml(-1) and to ropivacaine 1% 50-ml syringes to give a concentration of 45 micro g ml(-1). The polybags and syringes were stored at 40 degrees C, 21 degrees C and 4 degrees C for up to 120 days. Samples were taken during this period for measurement of diamorphine and ropivacaine content and pH of the solutions. RESULTS: We found that the storage temperature and the initial concentration influenced the rate of degradation of diamorphine in both the polybags and the syringes. In the syringes, 10% degradation of diamorphine [T (0.9)] was: 6 days at 40 degrees C, 16 days at 21 degrees C and 30 days at 4 degrees C. In the polybags, diamorphine T (0.9) was 6 days at 40 degrees C, 28 days at 21 degrees C and 70 days at 4 degrees C. CONCLUSIONS: It is feasible to manufacture such solutions in pharmacy aseptic units and to store them for up to 1 month for routine use in epidural infusions.

Amides↗
PubMed2000

Molecular analysis of the CDR3 encoding region of the immunoglobulin heavy chain locus in cerebrospinal fluid cells as a diagnostic tool in lymphomatous meningitis.

The diagnosis of leptomeningeal B-cell lymphoma is based on the identification of malignant B cells in the cerebrospinal fluid (CSF). Frequently, cytology does not allow clear distinction between neoplastic lymphoid cells and reactively transformed mononuclear cells. Individual B-cell clones can be identified on the basis of DNA sequences that encode the highly diverse complementarity-determining region (CDR3) of the immunoglobulin heavy chain locus (IgH). We studied CSF samples from 5 patients with B-cell malignancies and cytological evidence of leptomeningeal involvement, using polymerase chain reaction (PCR)-based high-resolution capillary electrophoresis and automated fluorescence analysis to detect PCR fragments. As controls, we assessed CSF specimens from 7 patients with inflammatory neurological diseases and three samples without pathological findings. In all patients with B-cell malignancies, a single PCR product was generated, indicating that CDR3-specific fragments were derived from monoclonal cell populations. CSF samples from patients with inflammatory diseases yielded multiple CDR3 amplicons, suggesting the presence of a polyclonal B-cell activation. No PCR product could be amplified in normal CSF samples. Automated fluorescence detection of CDR3 fragments is a highly sensitive and rapid method to distinguish neoplastic monoclonal and reactive polyclonal B-cell populations in the CSF.

Base Sequence↗
PubMed1992

Bacterial monitoring in vials using a spectrophotometric assimilation method.

Aseptic-filling processes are often used with fragile parenteral products that might be destroyed by terminal autoclaving. However, aseptic filling is not as effective as autoclaving in reducing contamination. As a result, time-consuming microbiological methods and turbidimetry are employed currently as product inspection techniques, but these processes can destroy the product and might not detect low levels of contamination. Thus, near-infrared (IR) light scattering was evaluated in this study as a new method for determining low levels of contamination noninvasively and nondestructively. A new parallel mathematical technique was used in conjunction with near-IR spectrophotometry to detect successfully contamination by several species of bacteria through intact glass vials. Using the near-IR method, products can be evaluated without introducing contamination, preserving the sample vial for dispensing or evaluation by another method.

Algorithms↗
PubMed1995

The effects of X-ray contrast media on bacterial growth.

Six widely used X-ray contrast media (XRC) were tested against nine commonly isolated organisms to determine the practicality of using XRC to outline body spaces prior to obtaining specimens for culture and to assess the feasibility of using XRC in divided doses to reduce cost. Preparations of Escherichia coli, Klebsiella pneumoniae, Enterococcus faecalis, Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Candida albicans, Streptococcus pyogenes and Streptococcus milleri in two approximate concentrations of 10(4) and 10(8) colony forming units/mL (cfu/mL) were inoculated into the following XRC: Conray 280, Hexabrix 320, lopamiro 370, Omnipaque 350, Ultravist 300 and Optiray 320 each in two concentrations. Sampling was performed in triplicate at 0, 2, 4 and 20 h with the 20 h counts made after exposure at both 22 degrees C and 4 degrees C. There were 16 significant interactions, predominantly with the Gram-negative organisms. Conray 280 produced the greatest number of effects. Most effects were bacteriostatic. Organisms were most susceptible at low concentration and after prolonged contact with XRC. No effect was seen with dilute XRC. All weekly sterility checks were negative. Non-ionic XRC have no significant effect on the growth of Gram-positive organisms and little effect on Gram-negative organisms if processing is performed promptly. Using standard aseptic technique, no contamination of XRC occurred, suggesting multi-dosing may be a safe and cost-effective method of XRC utilization.

Bacteria↗
PubMed1987

Antimicrobial alternatives for calf diarrhea: sera trace element responses to Escherichia coli-, deferoxamine-, or gallium-induced diarrhea.

Aseptic and septic inflammatory diseases often are associated with marked changes in tissue and sera trace element kinetics. Iron and zinc sequestration by the host may serve as a protective effect against microbial proliferation, but may deprive host tissues of these necessary elements as well. Conversely, systemic iron administration has been shown to increase susceptibility to, and severity of, infectious diseases, although deficient iron stores may be repleted. Escherichia coli enteritis in calves provides a model wherein the effects of enteric iron antagonism and parenteral iron supplementation may be studied simultaneously. Male calves (n = 12) were given (IM injection) 300 mg of iron-dextran after base-line blood samples were obtained, then the calves were allotted to 4 groups (each of 3 calves): group 1 (control)--orally given nonpathogenic E coli; group 2--orally given enterotoxigenic B44 E coli; group 3--orally given deferoxamine (50 mg/kg, twice a day); group 4--orally given gallium (4 mg/kg; twice a day). Calves were studied for 8 days; blood samples were obtained each day (day 1 through day 8) for hematologic and serum biochemical analyses. There were significant increases in serum iron concentration and % saturation in all calves within 24 hours of iron-dextran administration, which returned to base-line values in all but group 4 (given gallium) within 3 days. In the exceptional group (4), total iron-binding capacity decreased with time, as in the other groups, but serum iron concentration remained significantly increased, implying gallium interference with systemic iron assimilation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Severe damage of the femoral head after dislocation and difficult reduction maneuvers after total hip arthroplasty.

INTRODUCTION: Aseptic loosening associated with osteolysis and release of wear particles is the main reason for revision of total hip arthroplasty (THA). Damage of femoral heads is well known to increase the wear rate at the articulating surface. Instability and dislocation are serious complications and are the second most frequent reason for revision surgery after THA. In the present work the possible damaging of the femoral head as a result of difficult reduction maneuvers of dislocated THA should be investigated. PATIENTS AND METHODS: In three cases of total hip dislocation an open reduction was performed after dislocation of primary THA. Thereby one metal and two ceramic femoral heads were retrieved. Each head was analyzed macroscopically and by scanning electron microscopy (SEM) subsequently. RESULTS: In the first case the SEM analysis revealed severe titanium deposits on the retrieved ceramic head in the case of repeated unsuccessful closed reduction maneuvers. In the second case the retrieved ceramic head showed multiple scratches and a spalling of the surface structure. In the third case the retrieved metal head presented a roughened surface and severe scratches at the articulating area. DISCUSSION: Difficult reduction maneuvers following total hip dislocation can lead to severe damaging of the femoral head associated with an increase of the surface roughness. While repeated reduction maneuvers can lead to metallic deposits and spalling of the surface of ceramic heads, severe scratches can occur at metal heads. The damaging of the femoral head at the articulating surface can lead to increased wear and subsequent aseptic implant loosening. Therefore, open joint reduction has to be considered in cases of difficult or unsuccessful closed reduction maneuvers to prevent severe femoral head damage which may cause an increased release of wear particles.

Aged↗
PubMed2003

Frozen cancellous bone allografts: positive cultures of implanted grafts in posterior fusions of the spine.

We have carried out a study on the behaviour pattern of implanted allografts initially stored in perfect conditions (aseptically processed, culture-negative and stored at -80 degrees C) but which presented positive cultures at the implantation stage. There is no information available on how to deal with this type of situation, so our aim was to set guidelines on the course of action which would be required in such a case. This was a retrospective study of 112 patients who underwent a spinal arthrodesis and in whom a total of 189 allograft pieces were used. All previous bone and blood cultures and tests for hepatitis B and C, syphilis and HIV (via PCR techniques) were negative. The allografts were stored by freezing them at -80 degrees C. A sample of the allograft was taken for culture in the operating theatre just before its implantation in all cases. The results of the cultures were obtained 3-5 days after the operation. There were 22 allografts with positive culture results (12%) after implantation. These allografts were implanted in 16 patients (14%). Cultures were positive for staphylococci coagulase negative (ECN) in 10 grafts (46%), Pseudomonas stutzeri in two grafts (9%), Corynebacterium jeikeium in two grafts (9%), staphylococci coagulase positive in two grafts (9%) and for each of the following organisms in one case each (4%): Corynebacterium spp., Actinomyces odontolyticus, Streptococcus mitis, Peptostreptococcus spp., Rhodococcus equi and Bacillus spp. No clinical infection was seen in any of these patients. Positive cultures could be caused by non-detected contamination at harvesting, storing or during manipulation before implantation. The lack of clinical signs of infection during the follow-up of our patients may indicate that no specific treatment different from our antibiotic protocol is required in the case of positive culture results of a graft piece after implantation.

Adolescent↗
PubMed1998

[Presence of epithelial cells in the medullary canal after spinal anesthesia].

BACKGROUND AND AIM: Several authors have focused on a causal link between the onset of neurological complications after lumbar injections and the fact that epithelial cells may be drawn into the vertebral canal during these procedures. Complications may arise both early (cephalea, septic and aseptic meningitis) and late (epidermoid tumours). The authors aimed to evaluate whether skin fragments which are carried down by the needle during subarachnoid anesthesia may even be present in the epidural or subarachnoid space three days later and may therefore justify the onset of the above neurological syndromes. METHODS: Five adult cats under narcosis underwent subarachnoid anesthesia using disposable 22G Quincke type needles. Between 0.7 and 1 ml isobaric bupivacaine at 0.50% was injected. The presence of the motor block of the lower limbs was ascertained once the effects of general anesthesia wore off. On the third day, again under general anesthesia, cardio-respiratory arrest was provoked by intravenous injection. Samples of meninges were collected in the injection area. After fixation in a phosphate glutaraldehyde buffer, dehydration in acetone, dehydration by critical point and gold metalisation, the samples were examined using SEM. RESULTS: No epidermal cells were found on the surface of the meninges. On the other hand, a squamous epithelial cell was observed which drained inside a sectioned epidural vessel towards the systemic circulation. CONCLUSIONS: This study confirms the possibility that, after subarachnoid anesthesia using 22G Quincke needles, skin fragments may enter the spinal canal. The permanence or otherwise of the epithelial fragments on the third day depends on the size of the fragment drawn down and the efficacy of the drainage system which removes isolated epithelial cells. This phenomenon may justify the self-limiting character of cephalea and meningisms which, even if not treated, regress in a few days, as well as the scarce development of epidermoid tumours.

Anesthesia, Spinal↗
PubMed2006

Ultrasound therapy in tendinous injury healing in goats.

The effect of ultrasound therapy on tendon injury healing was studied on 12 locally available non-descript adult goats of either sex divided equally in two groups (I and II) consisting of six animals each. The superficial digital flexor tendon (SDFT) was transected and immediately repaired with nylon (2/0) using a locking loop suture pattern under atropine-triflupromazine-lignocaine epidural analgesia and strict aseptic condition. A full limb plaster of Paris cast was applied to immobilize the operated limb for 3 days. Postoperative care was similar in both the groups. In group I, the operated limb was allowed to heal without ultrasound therapy. In group II, pulsed ultrasound therapy was started 3 days after repair of tendinous injury at an intensity of 1 W/cm(2) for 10 min daily for 10 consecutive days. The animals of both groups were evaluated clinically and haemato-biochemically on days 1, 3, 7, 15, 20 and 30 postoperatively. Air tendonograms and ultrasonography were performed on days 0, 10, 20 and 30 post-tenorrhaphy. Histopathological examination of tendon biopsy samples was performed on day 30 post-tenorrhaphy. Resolution of inflammatory swelling, pain, weight bearing and tendon gliding movement was earlier in the test group than control. Rectal temperature, total leucocyte count and differential leucocyte count did not vary significantly at various stages of observation in both the groups. Serum glucose, cortisone and serum alkaline phosphatase levels increased significantly after tendon injury repair in all the animals and decreased slowly at all subsequent intervals in control group, whereas, it was near normal in the treatment group on day 30 post-tenorrhaphy. Air tendenograms and ultrasonography examinations in the test group revealed that there was a marked regression of peritendinous adhesion between the tendon and skin on day 30 post-tendon injury repaired and the tendon at the reconstructive site attained near normal thickness and density. Adhesions were present in the reconstructed site of SDFT in all animals of the control group. Histopathologically, the granulation tissue was comparatively bettered organized at the healing site in the ultrasound-treated animals.

Animals↗
PubMedDate not supplied

[Pseudomonas aeruginosa osteitis of the spinal process after peridural anesthesia].

BACKGROUND: Osteitis of the posterior wall of the spinal canal is an exceptional complication after peridural anesthesia. Prognosis depends on early diagnosis based on clinical signs and imaging data. CASE REPORT: A 73-year-old man was hospitalized for lower back pain and fever of 3 weeks duration after a total hip arthroplasty performed under general anesthesia. Computed tomography and magnetic resonance imaging of the lumbar spine disclosed osteitis of the spinal processes. Local bacteriology sample evidenced Pseudomonas aeruginosa. Outcome was favorable after a 6-month treatment. DISCUSSION: Data in the French and English literature (since 1948) on bone infections following epidural anesthesia have included 5 cases of spondylodiscitis and 1 case of posterior wall osteitis. The diagnosis is suggested by the clinical presentation. Standard x-rays contribute little. Early diagnosis in the infraradiological phase can be obtained with bone scintigraphy. Computed tomography or magnetic resonance imaging are currently highly contributive to diagnosis and follow-up after treatment. Contamination may be direct or via the blood stream or result from an extension of a neighboring infectious focus. Antibiotic therapy and immobilization are indicated. Rigorous application of strict aseptic procedures during lumbar puncture and use of the epidural catheter are crucial for prevention.

Aged↗
PubMed2005

The 'no-touch' method of intermittent urinary catheter insertion: can it reduce the risk of bacteria entering the bladder?

OBJECTIVE: This in vitro model was designed to determine whether using a no-touch method for catheter preparation and insertion would affect the degree of contamination transmitted to intermittent urinary catheters. SETTING: Northview Laboratories, Northbrook, IL 60062, USA. METHODS: This was a parallel experimental study conducted in vitro at an independent testing laboratory under Good Manufacturing Practices. Six different models of intermittent urinary catheter were tested in triplicate, in accordance with the manufacturer's Instructions For Use (IFU). Gloved hands were contaminated with a known amount of Staphylococcus aureus or Escherichia coli, preparation for insertion was mimicked according to the manufacturer's IFU. The number of bacteria transferred to the catheter was then quantified using a validated technique. The null hypothesis tested was that the bacterial contamination resulting from handling would be the same for all of the catheters. The primary outcome measure was the amount of bacteria, expressed as colony forming units (CFU), recovered from the catheters. The catheter wrappers were sampled to confirm that active transfer of microorganisms had taken place and nonhandled samples served as the negative controls. RESULTS: For both test organisms, the number of bacteria recovered from the catheters was significantly lower (P < 0.05) for the catheters featuring the no-touch design (approximately 5 CFU/plate versus 2.1 x 10(2) to 4.4 x 10(2) for the traditional hydrophilic catheters). The bacterial recovery from those catheters with the no-touch design often fell below the nominal detection limit. CONCLUSION: The results of this study allow the null hypothesis to be rejected; it can be concluded that the no-touch method provides a significant benefit in reducing the potential for external contamination of an intermittent urinary catheter. This result supports the recent recommendations for aseptic intermittent catheterization promoted within the guidelines issued by the European Association of Urologists (EAU).

Bacterial Physiological Phenomena↗
PubMedDate not supplied

[Value of prealbumin in the 1st and after the 12th day of life].

From a series of 129 neonates, well defined with regard to weight and gestational age, the authors established that serum concentration of prealbumin (PA) in an aseptic neonate depends on its gestational age on the first day of extrauterine life (p less than 0.001). Serum concentrations of PA are significantly different in appropriate for gestational age (AGA) and small for gestational age (SGA) neonates; this may be the consequence of insufficient materno-foetal transfers in the majority of SGA children. The study of the ratio maternal PA/neonatal PA at the time of delivery helps to establish the cause of SGA. On and after the 12th day of life, serum concentrations of PA are closely correlated with the usual data of anthropometry (weight, height, skull circumference) (p less than 0.001), when correlation is less close with gestational age at the time of sample taking: it may be used as a marker of the appropriateness of gestational age rather than of maturity. However, the ratio PA/weight varies from one child to another and from one week to another for a same child, giving PA a value different from ordinary anthropometry for the evaluation of the appropriateness of gestational size in neonates.

Anthropometry↗
PubMed2005

Epidemiological study of non-polio enterovirus neurological infections in children in the region of Monastir, Tunisia.

The epidemiological, virological, and clinical syndromes of 86 children younger than 13 years suspected of having neurological diseases and admitted to Fattouma Bourguiba Hospital of Monastir from January 2002 to November 2003 were analyzed. The presence of enterovirus was studied in cerebrospinal fluid (CSF) samples by reverse transcription-polymerase chain reaction (RT-PCR) and by isolation on cell culture. Sixty-one (71%) specimens were positive by RT-PCR, whereas 45 (52.3%) were detected by cell culture. Eighty percent (n = 36) of cultured enteroviruses were identified, whereas 20% were untyped. Echoviruses were isolated most frequently, with 32 cases (71.1%) in children. Echovirus 6 was the most commonly identified serotype (22.2%), followed by echovirus 13 (20%). The highest incidence on neurological infection (19.6%) occurred in children less than 6 months of age. The infected children were predominantly male (62.3%). Enteroviruses were detected in all the period of the year with the highest rate in the spring and summer months. Aseptic meningitis was the most commonly diagnosed disease (49%).

Adolescent↗