Detection rate, clinical characteristics, and molecular characterization of enterovirus and parechovirus infections in Thai infants during the first three months of life.

OBJECTIVES

To determine the detection rate, molecular characteristics, and clinical features of enterovirus and parechovirus infections in young infants with sepsis-like illness.

METHODS

A prospective study conducted from September 2023 to February 2025 at four Thai tertiary hospitals enrolled infants aged 0-3 months with sepsis-like symptoms who underwent routine laboratory tests and real-time reverse transcription polymerase chain reaction for enterovirus, human rhinovirus, and parechovirus.

RESULTS

Of 56 infants with sepsis-like illness, 15 tested positive (26.8%; 95%CI 17.0-39.6%) for enterovirus, human rhinovirus, or parechovirus. Detected viruses included echovirus 3 and 9 (n = 3), human rhinovirus types A, B, and C (n = 8), coxsackievirus A6 and B3 (n = 2), and parechovirus type 3 (n = 2). Virus-positive infants had a higher median age than virus-negative infants (39 vs. 15 days, p = 0.004), and neonates ≤ 1 month of age were usually virus-negative (p = 0.03). Virus-positive infants older than one month were more likely to have a temperature ≥ 37.5 °C (p = 0.03). Cough was more common in virus-positive infants, while abdominal distension was more frequent in virus-negative infants (p = 0.04).

CONCLUSION

Enteroviruses were commonly detected in Thai infants with sepsis-like illness, with most positives attributable to enterovirus/rhinovirus group viruses, whereas parechovirus was infrequent and limited to HPeV3. Genotyping indicated established circulating lineages.