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Measurement of the sensitivity of different commercial assays in the diagnosis of CMV infection in pregnancy

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Abstract

To evaluate the performance of different commercial assays for the detection of recent cytomegalovirus (CMV) in pregnancy, the sensitivity and specificity of assays for CMV-specific IgM antibodies were compared. Routine specimens from pregnant women were screened for CMV IgM using the Abbott AxSYM assay. Sera that were reactive according to AxSYM were further tested for IgM by other commercial assays. In selected IgM positive samples a CMV IgG avidity assay (Radim) and virus isolation from urine (shell vial) were also performed. The positivity rate for IgM anti-CMV by AxSYM was relatively high (140 out of 492, combining reactive and grayzone results). Only 26 of the 140 samples were positive for IgM according to Radim. The IgG avidity was low in 16 of the 43 samples tested, and the Radim and DiaSorin IgM assays were negative in 5 of them; 2 of the latter cases were also positive for viral isolation according to a shell vial method. There are differences in the sensitivity of the commercially available tests for CMV antibodies. CMV screening in pregnancy is performed as a first step by immunoassays and the choice of highly sensitive IgM test associated with further serological and virological methods could help to identify early primary infections.

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References

  1. Gaytant MA, Steegers EA, Semmekrot BA, Merkus HM, Galama JM (2002) Congenital cytomegalovirus infection: review of the epidemiology and outcome. Obstet Gynecol Surv 57:245–256. doi:10.1097/00006254-200204000-00024

    Article  PubMed  Google Scholar 

  2. Stagno S, Pass RF, Cloud G, Britt WJ, Henderson RE, Walton PD et al (1986) Primary cytomegalovirus infection in pregnancy. Incidence, transmission to fetus, and clinical outcome. JAMA 256:1904–1908. doi:10.1001/jama.256.14.1904

    Article  PubMed  CAS  Google Scholar 

  3. Munro SC, Hall B, Whybin R, Leader L, Robertson P, Maine GT et al (2005) Diagnosis of and screening for cytomegalovirus infection in pregnant women. J Clin Microbiol 43(9):4713–4718. doi:10.1128/JCM.43.9.4713-4718.2005

    Article  PubMed  CAS  Google Scholar 

  4. Boppana S, Pass RF, Britt WS, Stagno S, Alford CA (1992) Symptomatic congenital cytomegalovirus infection: neonatal and mortality. Pediatr Infect Dis J 11:93–99. doi:10.1097/00006454-199202000-00007

    PubMed  CAS  Google Scholar 

  5. Dahle AJ, Fowler KB, Wright JD, Boppana SB, Britt WJ, Pass RF (2000) Longitudinal investigation of hearing disorders in children with congenital cytomegalovirus. J Am Acad Audiol 11:283–290

    PubMed  CAS  Google Scholar 

  6. Fowler KB, McCollister FPE, Dahle AJ, Boppana SB, Britt J, Pas RF (1997) Progressive and fluctuating sensorineural hearing loss in children with asymptomatic congenital cytomegalovirus infection. J Pediatr 130:624–630. doi:10.1016/S0022-3476(97)70248-8

    Article  PubMed  CAS  Google Scholar 

  7. Whitley RJ, Kimberlin DW (1997) Treatment of viral infections during pregnancy and the neonatal period. Clin Perinatol 24:267–283

    PubMed  CAS  Google Scholar 

  8. Yow MD, Demmler GJ (1992) Congenital cytomegalovirus disease: 20 years is long enough. N Engl J Med 326:702–703

    Article  PubMed  CAS  Google Scholar 

  9. Adler PA, Nigro G, Pereira L (2007) Recent advances in the prevention and treatment of congenital cytomegalovirus infections. Semin Perinatol 31:10–18. doi:10.1053/j.semperi.2007.01.002

    Article  PubMed  Google Scholar 

  10. Nigro G, Adler SP, La Torre R, Best AM, for the Congenital Cytomegalovirus Collaborating Group (2005) Passive immunization during pregnancy for congenital cytomegalovirus infection. N Engl J Med 353:1350–1362. doi:10.1056/NEJMoa043337

    Article  PubMed  CAS  Google Scholar 

  11. Guerra B, Lazzarotto T, Quarta S, Lanari M, Bovicelli L, Nicolosi A et al (2000) Prenatal diagnosis of symptomatic congenital cytomegalovirus infection. Am J Obstet Gynecol 183:476–482. doi:10.1067/mob.2000.106347

    Article  PubMed  CAS  Google Scholar 

  12. Revello MG, Sarasini A, Zavattoni M, Baldanti F, Gerna G (1998) Improved prenatal diagnosis of congenital human cytomegalovirus infection by a modified nested polymerase chain reaction. J Med Virol 56:99–103. doi:10.1002/(SICI)1096-9071(199809)56:1<99::AID-JMV16>3.0.CO;2-R

    Article  PubMed  CAS  Google Scholar 

  13. Bodeus M, Hubinont C, Bernard P, Bouckaert A, Thomas K, Goubau P (1999) Prenatal diagnosis of human cytomegalovirus by culture and polymerase chain reaction: 98 pregnancies leading to congenital infection. Prenat Diagn 19:314–317. doi:10.1002/(SICI)1097-0223(199904)19:4<314::AID-PD542>3.0.CO;2-H

    Article  PubMed  CAS  Google Scholar 

  14. Tabor A, Philip J, Madsen M, Bang J, Obel EB, Norgaard-Pedersen B (1986) Randomised controlled trial of genetic amniocentesis in 4606 low-risk women. Lancet 1(8493):1287–1293. doi:10.1016/S0140-6736(86)91218-3

    Article  PubMed  CAS  Google Scholar 

  15. Landini MP, Lazzarotto T, Maine G, Ripalti A, Flanders R (1995) Recombinant mono- and polyantigens to detect cytomegalovirus-specific immunoglobulin M in human sera by enzyme immunoassay. J Clin Microbiol 33:2535–2542

    PubMed  CAS  Google Scholar 

  16. Nielsen SL, Sorensen I, Andersen HK (1988) Kinetics of specific immunoglobulins M, E, A, and G in congenital, primary, and secondary cytomegalovirus infection studied by antibody-capture enzyme-linked immunosorbent assay. J Clin Microbiol 26:654–661

    PubMed  CAS  Google Scholar 

  17. Grangeot-Keros L, Mayaux MJ, Lebon P, Freymuth F, Eugene G, Stricker R (1997) Value of cytomegalovirus (CMV) IgG avidity index for the diagnosis of primary CMV infection in pregnant women. J Infect Dis 175:944–946. doi:10.1086/513996

    Article  PubMed  CAS  Google Scholar 

  18. Lazzarotto T, Spezzacatena P, Pradelli P, Abate DA, Varani S, Landini MP (1997) Avidity of immunoglobulin G directed against human cytomegalovirus during primary and secondary infections in immunocompetent and immunocompromised subjects. Clin Diagn Lab Immunol 4:469–473

    PubMed  CAS  Google Scholar 

  19. Maine GT, Stricker R, Schuler M, Spesard J, Brojanac S, Iriarte B et al (2000) Development and clinical evaluation of a recombinant-antigen-based Cytomegalovirus Immunoglobulin M automated immunoassay using the Abbott AxSYM analyzer. J Clin Microbiol 38:1476–1481

    PubMed  CAS  Google Scholar 

  20. Gerna G, Baldanti F, Percivalle E, Zavattoni M, Campanili G, Revello MG (2003) Early identification of human cytomegalovirus strains by the shell vials is prevented by a novel amino acid substitution in UL123 IE1 gene product. J Clin Microb 41(9):4494–4495

    Article  CAS  Google Scholar 

  21. Gleaves CA, Smith TF, Shuster EA, Pearson GR (1984) Rapid detection of cytomegalovirus in MRC-5 cells inoculated with urine specimens by using low-speed centrifugation and monoclonal antibody to an early antigen. J Clin Microbiol 19:917–919

    PubMed  CAS  Google Scholar 

  22. Lazzarotto T, Guerra B, Lanari M, Gabrielli L, Landini MP (2008) New advances in the diagnosis of congenital cytomegalovirus infection. J Clin Virol 41:192–197. doi:10.1016/j.jcv.2007.10.015

    Article  PubMed  CAS  Google Scholar 

  23. Barbi M, Binda S, Caroppo S, Calvario A, Germinario C, Bozzi A et al (2006) Multicity Italian study of congenital cytomegalovirus infection. Pediatr Infect Dis J 25:156–159. doi:10.1097/01.inf.0000199261.98769.29

    Article  PubMed  Google Scholar 

  24. Puliyanda DP, Silverman NS, Lehman D, Vo A, Bunnapradist S, Radha RK et al (2005) Successful use of oral ganciclovir for the treatment of intrauterine cytomegalovirus infection in a renal allograft recipient. Transpl Infect Dis 7:71–74. doi:10.1111/j.1399-3062.2005.00089.x

    Article  PubMed  CAS  Google Scholar 

  25. Shen CY, Chang SF, Yen MS, Ng HT, Huang ES, Wu CW (1993) Cytomegalovirus excretion in pregnant and nonpregnant women. J Clin Microbiol 31(6):1635–1636

    PubMed  CAS  Google Scholar 

  26. Meier J, Lienicke U, Tschirch E, Krueger DH, Wauer RR, Proesch S (2005) Human cytomegalovirus reactivation during lactation and mother-to-child transmission in preterm infants. J Clin Microbiol 43:1318–1324. doi:10.1128/JCM.43.3.1318-1324.2005

    Article  PubMed  Google Scholar 

  27. Lazzarotto T, Galli C, Pulvirenti R, Rescaldani R, Vezzo R, La Gioia A et al (2001) Evaluation of the Abbott AxSYM cytomegalovirus (CMV) immunoglobulin M (IgM) assay in conjunction with other CMV IgM tests and a CMV IgG avidity assay. Clin Diagn Lab Immunol 8:196–198. doi:10.1128/CDLI.8.1.196-198.2001

    PubMed  CAS  Google Scholar 

  28. Goossens VJ, Vink C, Mullers W, Middeldorp JM, Bruggeman CA (2001) Different profiles of cytomegalovirus RNA transcripts and anti-cytomegalovirus IgM antibodies in renal transplant recipients. J Clin Virol 23:87–95. doi:10.1016/S1386-6532(01)00190-1

    Article  PubMed  CAS  Google Scholar 

  29. Kraat YJ, Stals FS, Landini MP, Bruggeman CA (1993) Cytomegalovirus IgM antibody detection: comparison of five assays. Microbiologica 16:297–307

    PubMed  CAS  Google Scholar 

  30. Kraat YJ, Stals FS, Christiaans MH, Lazzarotto T, Landini MP, Bruggeman CA (1996) IgM antibody detection of ppUL80A and ppUL32 by immunoblotting: an early parameter for recurrent cytomegalovirus infection in renal transplant recipients. J Med Virol 48:289–294. doi:10.1002/(SICI)1096-9071(199603)48:3<289::AID-JMV13>3.0.CO;2-8

    Article  PubMed  CAS  Google Scholar 

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Gentile, M., Galli, C., Pagnotti, P. et al. Measurement of the sensitivity of different commercial assays in the diagnosis of CMV infection in pregnancy. Eur J Clin Microbiol Infect Dis 28, 977–981 (2009). https://doi.org/10.1007/s10096-009-0738-0

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