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Human Parechovirus Infection in Neonatal Intensive Care

Davis, Jonathan MD*; Fairley, Derek PhD; Christie, Sharon MD; Coyle, Peter MD; Tubman, Richard MD; Shields, Michael D. MD§¶

Pediatric Infectious Disease Journal: February 2015 - Volume 34 - Issue 2 - p 121–124
doi: 10.1097/INF.0000000000000510
Original Studies

Background: Approximately 5–6% of all infective episodes in neonatal intensive care unit (NICU) are of viral origin. Previous studies suggest that human parechovirus (HPeV) infection presents most commonly in term infants, as a sepsis-like syndrome in which meningoencephalitis is prominent. Our aim was to study the infection rate and associated features of HPeV.

Methods: Blood samples were taken from NICU babies older than 48 hours, who were being investigated for late onset sepsis. Clinical and laboratory data were collected at the time of the suspected sepsis episode. Samples were tested using universal primers and probe directed at the 5′-untranslated region of the HPeV genome by reverse transcriptase polymerase chain reaction (RT-PCR). Results were confirmed by electrophoresis and DNA sequencing.

Results: HPeV was detected in 11 of 84 samples (13%). These infants had a mean [interquartile range (IQR)] gestational age of 28.9 (26.9–30.6) weeks and mean birth weight of 1.26 (SD = 0.72) kg. The median day of presentation was 16 (IQR: 11–27). These characteristics were similar to the infants without positive viral detection. Six infants presented with respiratory signs. One infant presented with signs of meningitis. Six of the 11 episodes of HPeV infection occurred during the winter months (December to February). No HPeV positive infants had abnormal findings on their 28-day cranial ultrasound examination.

Conclusions: We found an HPeV infection rate of 13% in infants being tested for late onset sepsis. HPeV should be considered as a possible cause of sepsis-like symptoms in preterm infants.

From the *Regional Neonatal Unit, St. Michael’s Hospital, University Hospitals Bristol Foundation Trust, Bristol; Microbiology, Belfast Health and Social Services Trust; Royal Jubilee Maternity Hospital; §Royal Belfast Hospital for Sick Children, Belfast Health and Social Services Trust; and Centre for Infection and Immunity, Queens University of Belfast, Belfast, United Kingdom

Accepted for publication July 24, 2014.

The authors have no conflicts of interest to disclose.

J.D. was supported by the Royal Hospitals Fellowship fund, Children’s Haematology fund the Perinatal Fund, Northern Ireland.

Address for correspondence: Jonathan Davis, MD, Regional Neonatal Intensive Care Unit, St. Michael’s Hospital, University Hospitals Bristol Foundation Trust, Southwell Street, Bristol BS28EG, United Kingdom. E-mail: jonathan.davis@bristol.ac.uk.

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