ArticleThe Lancet. Infectious diseases2018
Assessment of blood enterovirus PCR testing in paediatric populations with fever without source, sepsis-like disease, or suspected meningitis: a prospective, multicentre, observational cohort study.
Article in The Lancet. Infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04711876 (Study of the Inflammatory Response to Enterovirus Meningitis in Newborns, Infants and Children, as Assessed by Cytokine Levels in Blood and Cerebrospinal Fluid. Case-control Comparison Using an Existing Cohort.), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Study of the Inflammatory Response to Enterovirus Meningitis in Newborns, Infants and Children, as Assessed by Cytokine Levels in Blood and Cerebrospinal Fluid. Case-control Comparison Using an Existing Cohort.
Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Molecular assays for the diagnosis of sepsis in neonates: a diagnostic test accuracy review.The Cochrane database of systematic reviews · 2025Pooled it
- Absent pleocytosis in infant viral central nervous system infections reflects lymphocyte depletion and cytokine activation.Nature communications · 2026Article
- Differential cytokine signature profiles in neonates, infants, and children with enterovirus meningitis.Journal of virology · 2026Observational
- Emergence and circulation of enterovirus B species in infants in southern China: A multicenter retrospective analysis.Virulence · 2024Article
- Article
- Prospective multicenter evaluation of adherence to the Dutch guideline for children aged 0-16 years with fever without a source-febrile illness in children (FINCH) study.European journal of pediatrics · 2024Observational
- Diagnosis, management, and outcomes of parechovirus infections in infants: an overview.Journal of clinical microbiology · 2024Review
- Respiratory viral detection in the plasma and cerebrospinal fluid (CSF) of young febrile infants.Influenza and other respiratory viruses · 2024Article
- Article
- Aetiology of Acute Undifferentiated Fever Among Children Under the Age of Five in Vietnam: A Prospective Study.Journal of epidemiology and global health · 2023Article
- [A cross-sectional study of enterovirus nucleic acid test with throat swabs for term late neonates during coronavirus disease 2019].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- A one-step reverse-transcription recombinase aided PCR assay for the rapid and sensitive detection of human enteroviruses.Biosafety and health · 2023Article
- Enterovirus B types cause severe infection in infants aged 0-3 months.Virology journal · 2023Article
- Severe neonatal enterovirus infection in twins with different outcomes: A case report.Frontiers in pediatrics · 2023Article
- Structural Studies Reveal that Endosomal Cations Promote Formation of Infectious Coxsackievirus A9 A-Particles, Facilitating RNA and VP4 Release.Journal of virology · 2022Article
- Evidence of pediatric sepsis caused by a drug resistantEmerging microbes & infections · 2022Article
- Enteroviral Infections in the First Three Months of Life.Pathogens (Basel, Switzerland) · 2022Review
- Striking Decrease of Enteroviral Meningitis in Children During the COVID-19 Pandemic.Open forum infectious diseases · 2021Article
- A multicenter evaluation of viral bloodstream detections in children presenting to the Emergency Department with suspected systemic infection.BMC pediatrics · 2021Article
- Neonatal sepsis: within and beyond China.Chinese medical journal · 2020Review
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Authors and funding
21 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnteroviruses are the most frequent cause of acute meningitis and are seen increasingly in sepsis-like disease and fever without source in the paediatric population. Detection of enterovirus in cerebrospinal fluid (CSF) specimens by PCR is the gold standard diagnostic test. Our aim was to assess a method of detecting enterovirus in blood specimens by PCR.
methodsWe did a prospective, multicentre, observational study at 35 French paediatric and emergency departments in 16 hospitals. We recruited newborn babies (aged ≤28 days) and infants (aged >28 days to ≤2 years) with fever without source, sepsis-like disease, or suspected meningitis, and children (aged >2 years to ≤16 years) with suspected meningitis, who were admitted to a participating hospital. We used a standardised form to obtain demographic, clinical, and laboratory data, which were anonymised. Enterovirus PCR testing was done in blood and CSF specimens.
findingsBetween June 1, 2015, and Oct 31, 2015, and between June 1, 2016, and Oct 31, 2016, we enrolled 822 patients, of whom 672 had enterovirus PCR testing done in blood and CSF specimens. Enterovirus was detected in 317 (47%) patients in either blood or CSF, or both (71 newborn babies, 83 infants, and 163 children). Detection of enterovirus was more frequent in blood samples than in CSF specimens of newborn babies (70 [99%] of 71 vs 62 [87%] of 71; p=0·011) and infants (76 [92%] of 83 vs 62 [75%] of 83; p=0·008), and was less frequent in blood samples than in CSF specimens of children (90 [55%] of 163 vs 148 [91%] of 163; p<0·0001). Detection of enterovirus was more frequent in blood samples than in CSF specimens of infants aged 2 years or younger with fever without source (55 [100%] of 55 vs 41 [75%] of 55; p=0·0002) or with sepsis-like disease (16 [100%] of 16 vs nine [56%] of 16; p=0·008). Detection of enterovirus was less frequent in blood than in CSF of patients with suspected meningitis (165 [67%] of 246 vs 222 [90%] of 246; p<0·0001).
interpretationTesting for enterovirus in blood by PCR should be an integral part of clinical practice guidelines for infants aged 2 years or younger. This testing could decrease the length of hospital stay and reduce exposure to antibiotics for low-risk patients admitted to the emergency department with febrile illness.
fundingUniversity Hospital Clermont-Ferrand.
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