Distribution of species enterovirus B in patients with central nervous system infections in Sao Paulo State, Brazil

Enteroviruses (EV) are most common cause of central nervous system (CNS) infection, mainly aseptic meningitis. In Brazil, data available concerning the distribution of EV types are scarce. The aim of this study was to describe of types EV in patients with infection of the CNS in Sao Paulo State. This retrospective study was conducted in clinical samples collected from patients with infections of the CNS from 2004 to 2014. We investigated the presence of EV by virus isolation in cell culture. The samples that showed cytopathic effect in the cell culture were submitted by indirect immunofluorescence assay, reverse transcription polymerase chain reaction and VP1 partial sequencing to identification of EV isolated. A total of 176 EV isolated in cell culture was detected and typed in 14.5% (n = 176/1215) of clinical samples analyzed; corresponding to 71.0% of AM, and 19.3% of encephalitis and meningoencephalitis. Echoviruses (E) were isolated most frequently, with 155 strains (88.1%), Coxsackievirus B (CV-B), with 20 cases (11.4%), CV-A, with 01 case (0.6%). E-6 was the most commonly identified followed in decreasing order by E-30; E-18; CV-B5; E-4; E-11; CV-B2 and E-9; E-7; CV-A9, CV-B1, CV-B3, CV-B4, E-13, E-14, and E-21. EV detected were classified as belonging to the species enterovirus B. EV were detected in all the period of the year with the highest rate in the spring and summer months. Data obtained in this study contribute to the knowledge about EV circulation implicated in CNS infections over a 11-year period in Sao Paulo State, Brazil.