Next generation sequencing approaches for the detection and characterization of enteroviruses in clinical, public health, and research settings: Expert view of the European non-polio enterovirus network (ENPEN)


Por: Benschop KSM, Zwagemaker F, Andersson-Li L, Andrés C, Antón A, Berengua C, Berginc N, Bessaud M, Bisseux M, Bujaki E, Canning B, Christiansen CB, Couderé K, Broberg EK, Cassidy H, Castilletti C, Celma C, Cinek O, Deézsi-Magyar N, Eis-Hübinger AM, Flipse J, Jirincová H, Gatej R, Georgieva I, Giardina F, González-Sánchez A, Hack B, Helfferich J, Hutchings S, Hietanen E, Hönemann M, Virant MJ, Kalogera E, Johannesen CK, Kenicer J, Kleines M, Lagarejos E, Landaas ET, Kandulu CC, Xavier López Labrador F, Lunar MM, Maier M, Majumdar M, Martin J, McClure CP, Munoz-Almagro C, Ošep A, Øverbø J, Palminha P, Papa A, Pariani E, Pellegrinelli L, Pietsch C, Piralla A, Poljak M, Pomari E, Prats-Méndez I, Rector A, Reuter G, Riess M, Ruta S, Schibler M, Nilsen HS, Simmonds P, Sourvinos G, Szomor K, Susi P, Tabain I, Vallely P, von Eije KJ, Weil M, Wieczorek M, Wollants E, Wolthers KC, Zuckerman NS, Fischer TK and Harvala H

Publicada: 1 jun 2026 Ahead of Print: 24 mar 2026
Resumen:
Enteroviruses (EVs) are a common cause of a wide spectrum of infectious diseases, ranging from mild respiratory illnesses to severe neurological conditions, particularly affecting children. Current molecular methods, such as 5'UTR-based PCR for detection and (partial) VP1 gene sequencing for typing, are widely utilized. However, Next-Generation Sequencing (NGS), and bioinformatics offer a comprehensive alternative, enabling full-genome analyses for improved virus characterization, genomic epidemiological surveillance, and outbreak investigation. Despite its advantages, implementation of NGS poses challenges, particularly in standardizing and optimizing laboratory workflows (wet-lab) and bioinformatics analyses (dry-lab), methods that are not often readily accessible in many laboratories. Here, we discuss the potential of NGS as a tool for EV detection/characterization in clinical virology, public health, and research settings. We provide practical options for actions for implementing NGS to advance the understanding and management of enterovirus infections. These recommendations are based on expert discussions during the recent European non-polio enterovirus network (ENPEN) workshop held in Corfu, Greece, on 23-24 May 2024, aiming to guide harmonization of NGS practices across clinical, public health, and research settings.

Filiaciones:
Benschop KSM:
 Centre for Infectious Disease Control (CIb), Centre for Infectious Disease Research, Diagnostics and laboratory Surveillance (IDS) Dutch National Institute for Public Health and the Environment, Bilthoven, the Netherlands

Zwagemaker F:
 Centre for Infectious Disease Control (CIb), Centre for Infectious Disease Research, Diagnostics and laboratory Surveillance (IDS) Dutch National Institute for Public Health and the Environment, Bilthoven, the Netherlands

Andersson-Li L:
 Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Sweden

Andrés C:
 Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Spain

Antón A:
 Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Spain

Berengua C:
 Microbiology Department. Hospital Universitari de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

Berginc N:
 National Laboratory of Health, Environment and Food, Laboratory for Public Health Virology, Ljubljana, Slovenia

Bessaud M:
 Institut Pasteur, Université de Paris Cité, CNRS UMR 3569, Virus sensing & signaling Unit, Paris, France

Bisseux M:
 CHU Clermont-Ferrand, 3 IHP, National Reference Centre for enteroviruses and parechoviruses, Clermont-Ferrand, France

Bujaki E:
 Division of Vaccines, Science and Research, Medicines and Healthcare products Regulatory Agency, South Mimms, (MHRA), Hertfordshire EN6 3QG, United Kingdom

Canning B:
 Clinical Microbiology, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, United Kingdom

Christiansen CB:
 Department of Clinical microbiology, Lund University Hospital, Lund, Sweden

Couderé K:
 ElisabethTweesteden Hospital, Tilburg, the Netherlands

 Zorgsaam, Terneuzen, the Netherlands

Broberg EK:
 European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden

Cassidy H:
 Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands

Castilletti C:
 Department of Infectious, Tropical Diseases and Microbiology - IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy

Celma C:
 Enteric Virus Unit, Virus Reference Department, UK Health Security Agency, London, United Kingdom

Cinek O:
 Department of Microbiology, Second Faculty of Medicine, Charles University, and University Hospital Motol, Prague, Czech Republic

Deézsi-Magyar N:
 National Biosafety Laboratory, National Center for Public Health and Pharmacy, Budapest, Hungary

Eis-Hübinger AM:
 Institute of Virology, University Hospital Bonn, Germany

Flipse J:
 Laboratory for Medical Microbiology and Immunology, Dicoon, Elst, the Netherlands

Jirincová H:
 National Reference Laboratory for Enteroviruses, National Institute of Public Health, Prague, Czech Republic

Gatej R:
 National Institute of Public Health, Bucharest, Romania

Georgieva I:
 National Reference Laboratory for Enteroviruses, Department of Virology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria

Giardina F:
 Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

González-Sánchez A:
 Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Spain

Hack B:
 Infectious Diseases and Microbiology Department, Guy's and St Thomas' NHS Foundation Trust, United Kingdom

Helfferich J:
 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands

Hutchings S:
 Virology laboratory, Bristol, United Kingdom Health Security Agency, Bristol, United Kingdom

Hietanen E:
 Astbury Centre for Structural Molecular Biology, School of Molecular & Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom

Hönemann M:
 Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany

Virant MJ:
 Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia

Kalogera E:
 Microbiology Department, Agia Sofia Children's Hospital, Athens, Greece

Johannesen CK:
 Department of Clinical Research, Nordsjællands Hospital, Hilleroed, Denmark

Kenicer J:
 Pathogen Sequencing Service, Specialist Virology Centre, Edinburgh, Royal Infirmary of Edinburgh, Edinbrugh, Scotland, United Kingdom

Kleines M:
 Laboratory Diagnostic Center, University Hospital RWTH Aachen, Aachen, Germany

Lagarejos E:
 Microbiology Department, Doctor Negrin Gran Canaria's Universitary Hospital, Gran Canaria, Spain

Landaas ET:
 Department of Microbiology, Oslo University Hospital, Oslo, Norway

 Institute of Clinical Medicine, University of Oslo, Oslo, Norway

Kandulu CC:
 Pharmaceutical Care Research Group, University College Cork, Cork, Ireland

Xavier López Labrador F:
 CIBERESP, Instituto de Salud Carlos III, Madrid, Spain

 Virology Laboratory, Genomics and Health Area, Center for Public Health Research (FISABIO - Public Health), Valencia, Spain

 Department of Microbiology & Ecology, University of Valencia Medical School, Spain

Lunar MM:
 Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia

Maier M:
 Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany

Majumdar M:
 Division of Vaccines, Science and Research, Medicines and Healthcare products Regulatory Agency, South Mimms, (MHRA), Hertfordshire EN6 3QG, United Kingdom

Martin J:
 Division of Vaccines, Science and Research, Medicines and Healthcare products Regulatory Agency, South Mimms, (MHRA), Hertfordshire EN6 3QG, United Kingdom

McClure CP:
 Wolfson Centre for Global Virus Research, School of Life Sciences, University of Nottingham, Nottingham, United Kingdom

Munoz-Almagro C:
 Grupo de Investigación en Enfermedades Infecciosas y Microbioma, Institut de Recerca Sant Joan de Déu,Institut Recerca Sant Joan de Deu-Hospital Sant Joan de Deu, CIBER de Epidemiología y Salud Pública- CIBERESP, Medicine Department, Universitat Internacional de Catalunya, Spain

Ošep A:
 Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia

Øverbø J:
 Department of Virology, Norwegian Institute of Public Health, Norway

Palminha P:
 National Reference Laboratory for Influenza and Other Respiratory Viruses, National Institute of Health Dr Ricardo Jorge (INSA), Lisbon, Portugal

Papa A:
 Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

Pariani E:
 Department of Biomedical Sciences for Health, University of Milan, Milano (MI), Italy

Pellegrinelli L:
 Department of Biomedical Sciences for Health, University of Milan, Milano (MI), Italy

Pietsch C:
 Institute of Medical Microbiology and Virology, University of Leipzig, Leipzig, Germany

Piralla A:
 Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Poljak M:
 Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Slovenia

Pomari E:
 Department of Infectious, Tropical Diseases and Microbiology - IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy

Prats-Méndez I:
 Respiratory Viruses Unit, Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Spain

Rector A:
 Department of Microbiology, immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Reference center for Enterovirus, KU Leuven, Rega Institute, Belgium

Reuter G:
 Department of Medical Microbiology and Immunology, Medical School, University of Pécs, Hungary

Riess M:
 European Centre for Disease Prevention and Control, (ECDC), Stockholm, Sweden

Ruta S:
 Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

 Stefan S Nicolau Institute of Virology, Bucharest, Romania

Schibler M:
 Laboratory of Virology, Division of Laboratory Medicine, Division of Infectious Diseases, Geneva University Hospitals, Switzerland

Nilsen HS:
 Department of Medical Microbiology, St. Olavs Hospital, Trondheim University Hospital, Norway

Simmonds P:
 Nuttfield Department for Medicine, University of Oxford, Oxford, United Kingdom

Sourvinos G:
 Laboratory of Clinical Virology, Medical School, University of Crete, Crete, Greece

Szomor K:
 National WHO Poliovirus Reference Laboratory, National Center for Public Health and Pharmacy, Budapest, Hungary

Susi P:
 Institute of Biomedicine, University of Turku, Finland

Tabain I:
 Microbiology Division, Croatian Institute of Public Health, Zagreb, Croatia

Vallely P:
 Microbiology and Virology Unit, Division of Evolution, Infection and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchestar, United Kingdom

von Eije KJ:
 Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands

Weil M:
 Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel

Wieczorek M:
 Department of Virology, National Institute of Public Health NIH - National Institute of Research, Warsaw, Poland

Wollants E:
 Department of Microbiology, immunology and Transplantation, Laboratory of Clinical and Epidemiological Virology, Reference center for Enterovirus, KU Leuven, Rega Institute, Belgium

Wolthers KC:
 OrganoVIR Labs, Dept of Medical Microbiology and Infection prevention, Amsterdam UMC location AMC, Amsterdam, the Netherlands

Zuckerman NS:
 Central Virology Laboratory, Public Health Services, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel

Fischer TK:
 Department of Clinical Research, Nordsjællands Hospital, Hilleroed, Denmark

 Department of Public Health, University of Copenhagen, Copenhagen, Denmark

 Pandemix Center for Excellence (DNRF 170), Roskilde University, Roskilde, Denmark

Harvala H:
 Nuttfield Department for Medicine, University of Oxford, Oxford, United Kingdom

 NHS Blood and Transplant, Microbiology Services, Colindale, United Kingdom

 Clinical Microbiology, Turku University Hospital and Institute of Biomedicine, University of Turku, Turku, Finland
ISSN: 13866532





JOURNAL OF CLINICAL VIROLOGY
Editorial
ELSEVIER, RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS, Países Bajos
Tipo de documento: Article
Volumen: 184 Número:
Páginas: 105940-105940
WOS Id: 001747254400001
ID de PubMed: 41905022
imagen Green Submitted, Green Published, hybrid

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