Viral Metagenomic Analysis of Cerebrospinal Fluid from Patients with Acute Central Nervous System Infections of Unknown Origin, Vietnam

• Published in: Emerging infectious diseases Vol. 27; no. 1; pp. 205 - 213
• Main Authors: Anh, Nguyen To, Nhu, Le Nguyen Truc, Hong, Nguyen Thi Thu, Phuc, Tran My, Tam, Pham Thi Thanh, Huong, Dang Thao, Anh, Tran Tuan, Deng, Xutao, Nghia, Ho Dang Trung, Nguyen, Tran Thua, Van Hung, Nguyen, Thuan, Nguyen Dac, Phuong, Pham Thi Hong, Chau, Nguyen Van Vinh, Baker, Stephen, Delwart, Eric, Thwaites, Guy, Van Tan, Le
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.01.2021; Centers for Disease Control and Prevention
• Subjects: Care and treatment; Central nervous system; Central nervous system diseases; central nervous system infection; Central Nervous System Infections - diagnosis; Central Nervous System Infections - epidemiology; Cerebrospinal Fluid; Diagnosis; Encephalitis; enterovirus; Enterovirus - genetics; Enterovirus Infections; Genetic aspects; Genome-wide association studies; Genotype; Health aspects; Human papillomavirus; Humans; Identification and classification; Infections; Metagenomics; Methods; Mollusks; Nervous system; next-generation sequencing; Pathogens; Phylogenetics; Public health; Surveillance; Vietnam; Vietnam - epidemiology; Viral Metagenomic Analysis of Cerebrospinal Fluid from Patients with Acute Central Nervous System Infections of Unknown Origin, Vietnam; viral metagenomics; Virus diseases; Viruses; West Nile virus; Vietnam; Vietnam; viruses; enterovirus; next-generation sequencing; viral metagenomics; central nervous system infection; meningitis/encephalitis
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid2701.202723

Central nervous system (CNS) infection is a serious neurologic condition, although the etiology remains unknown in >50% of patients. We used metagenomic next-generation sequencing to detect viruses in 204 cerebrospinal fluid (CSF) samples from patients with acute CNS infection who were enrolled from Vietnam hospitals during 2012-2016. We detected 8 viral species in 107/204 (52.4%) of CSF samples. After virus-specific PCR confirmation, the detection rate was lowered to 30/204 (14.7%). Enteroviruses were the most common viruses detected (n = 23), followed by hepatitis B virus (3), HIV (2), molluscum contagiosum virus (1), and gemycircularvirus (1). Analysis of enterovirus sequences revealed the predominance of echovirus 30 (9). Phylogenetically, the echovirus 30 strains belonged to genogroup V and VIIb. Our results expanded knowledge about the clinical burden of enterovirus in Vietnam and underscore the challenges of identifying a plausible viral pathogen in CSF of patients with CNS infections.