Summary
With the advent of effective therapy rapid, sensitive and reliable assays for diagnosis of human cytomegalovirus (HCMV) infections are required. In a total of 1,928 urine samples, detection of HCMV-immediate early antigen in a spin amplified microplate culture by a monoclonal antibody and immunoperoxidase staining (EA-assay) was compared with virus isolation in cell culture. Sensitivity of the EA assay was 85.5% and specificity was 99.5% compared with virus isolation. Overall agreement of both assays was 97.8%. In addition, in 235/1,928 urine samples amplification of HCMV-DNA was performed by means of polymerase chain reaction (PCR) using primers from the immediate early (IE1) gene region and 141/1,928 using primers from the late region (LA). The sensitivity of PCR compared with virus isolation was 67.8% for IE1 primers and 94.1% for LA primers (statistical significance: p<0.01, Chi-square-test). Overall agreement between virus isolation and PCR was 88.5% for IE1-PCR and 84.4% for LA-PCR. Discordant results were more often found in adults with acute infection and immunocompromised patients than in infants.
Zusammenfassung
Schnelle und verläßliche Teste für die Diagnostik von Zytomegalie- (CMV) Infektionen sind besonders seit dem Aufkommen einer effektiven antiviralen Therapie gefordert. Bei insgesamt 1928 Urinproben wurde der Nachweis von CMV-Frühantigen in Zentrifugationskultur (Mikrotiterplatte) mit einem monoklonalen Antikörper und Immunperoxidase-Färbung (Early-Antigen-Test) mit der herkömmlichen Virusisolierung in Zellkultur verglichen. Die Sensitivität des Early-Antigen-Tests betrug 85,5%, die Spezifität 99,5% im Vergleich zur Virusisolierung. Die Übereinstimmung beider Tests war 97,8%. Zusätzlich erfolgte in 235 der 1928 Urinproben der Nachweis von CMV-DNS mittels Polymerase-Kettenreaktion (PCR) mit Primern aus dem Bereich des viralen Immediate-Early-Gens (IE1) und in 141 der 1928 Proben mit Primern aus dem Bereich des Late-Gens (LA). Im Vergleich zur Virusisolierung erreichte die PCR eine Sensitivität von 67,8% mit IE1-Primern und von 94,1% mit LA-Primern (statistische Signifikanz: p<0.01, Chi-square-Test). Die Übereinstimmung von Virusisolierung und PCR betrug 88,5% (IE1) und 84,4% (LA). Bei Erwachsenen mit akuter Infektion und Immunsupprimierten Patienten waren die Ergebnisse weniger übereinstimmend als bei Kindern.
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Daiminger, A., Schalasta, G., Betzl, D. et al. Detection of human cytomegalovirus in urine samples by cell culture, early antigen assay and polymerase chain reaction. Infection 22, 24–28 (1994). https://doi.org/10.1007/BF01780759
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DOI: https://doi.org/10.1007/BF01780759