Parechovirus PCR - stool specimen
- LIS Mnemonic: PAREPCR
Collect
Stool in a sterile, leak-proof container
Volume Required
2 to 4 ml of liquid stool; 2 to 4 grams of formed stool
Minimum Required
2 ml of liquid stool; 2 grams of formed stool
Transport
Keep specimen at 4C
Stability
Labile
Processing
The specimen of choice is stool. Rectal swabs are inferior to stool specimens for the detection of viruses and are discouraged. If it is necessary to collect a rectal swab, a sufficient quantity of fecal material (at least a pea-sized amount) should be obtained. If fecal material is not clearly visible on the swab, the specimen is most likely inadequate. Rectal swabs should be immediately placed in viral transport medium. Specimens should be transported to the laboratory as quickly as possible after collection. When immediate transport is not possible, refrigerate the specimens or keep them on wet ice. For delays of more than 24-48 hours (e.g., when shipping specimens from an outside facility), specimens should be processed as needed and rapidly frozen to -70C and then transported to the laboratory on dry ice.
Unacceptable conditions
Specimens for molecular testing should not be stored at room temperature or frozen at -20C. This is critical to ensure the stability and amplification of nucleic acids, particularly for the detection of RNA viruses since RNA is unstable and easily degraded by RNAses from the surrounding environment.
Days Performed
Daily
Reported
Same day
Reflex Testing
N/A
CPT
87798
Methodology
Amplification and detection of parechovirus RNA from the highly conserved 5'-untranslated region of the genome using TaqMan real-time PCR technology. This test is performed pursuant to an agreement with Roche Molecular Systems, Inc.
Interpretation
If positive, results are reported as parechovirus RNA detected.
Reference Values
Negative or no parechovirus RNA detected
Remarks
Human parechoviruses are small, RNA viruses related to, but genetically distinct from, the enteroviruses commonly seen in our pediatric population. Similar to enteroviruses, infections with parechoviruses are frequent and significant in infants and young children. The spectrum of clinical diseases is comparable to that of the enteroviruses and includes acute respiratory and gastrointestinal illnesses, neonatal sepsis, aseptic meningitis, encephalitis, myocarditis, acute flaccid paralysis, and necrotizing enterocolitis. Detection of parechovirus by PCR may be enhanced by collecting specimens from multiple body sites. These may include CSF, urine, blood, respiratory, stool, tissue (e.g., colon, myocardium), and sterile body fluids (e.g., pericardial fluid). For diagnosis of neonatal sepsis, send both blood and urine as primary sources; also send CSF, respiratory, and stool samples if symptoms of central nervous system (CNS), respiratory and/or gastrointestinal involvement. Send CSF as the primary specimen in patients with aseptic meningitis or other CNS diseases; also send blood and urine on all patients with CNS disease to increase the likelihood of finding the virus. In addition, respiratory and stool samples may be sent on patients with respiratory and/or gastrointestinal symptoms. Please Note: Despite studies showing respiratory and gastrointestinal symptoms in association with parechovirus infections, the role of this virus in causing respiratory or enteric disease has not been fully established and positive results from only respiratory and stool specimens may not always correlate with disease because of prolonged viral shedding.
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