Comparative study between two methods for detecting cytomegalovirus in chronic renal failure patients

This work was- designed to evaluate and compare Human Cytomegalovirus [HCMV] ELISA and Polymerase chain reaction PCR methods for the detection of HCMV in chronic renal failure patients. Also, it aims to correlate HCMV infection with positive clinical history, duration of dialysis, blood transfusion and renal transplantation. The present study was conducted on 66 patients with chronic renal failure, divided into two subgroups [50 non-transplanted on hemodialysis and 16 renal transplanted patients], and twenty apparently healthy volunteers as control group. Both the patients and the controls have been studied for detection of HCMV infection by CMV specific IgG and IgM ELISA assay, and qualitative leukocytes PCR assay. Regarding CMV IgG and IgM were detected in 66 [100%] and 10 [15.1%] patients respectively. The patients' group was found to be positive for CMV IgM and PCR assays in a percentage of 15.1% and 45.4% respectively with statistically significant difference compared to the control group. By PCR, HCMV positivity was significantly increased more frequent among non-transplanted patients with frequent blood transfusion. However, frequent blood transfusion had no influence on the positivity of HCMV in renal transplanted patients. Also, duration of dialysis In non-transplanted patients had insignificant role on the positivity of HCMV. Although the positivity for CMV IgM ELISA was [12%] and [25%] among non-transplanted and transplanted subgroups respectively, the difference was statistically insignificant. Comparing the positivity for PCR which was [42%] and [56.25%] among non-transplanted and transplanted subgroups respectively, the difference was also statistically insignificant. The relative sensitivity and specificity of CMV IgM ELISA assay compared to CMV PCR were 30% and 97.2% respectively. We concluded that leukocytes PCR is a reliable test in screening HCMV infection and it is more valuable than serology in diagnosis of HCMV infection. Also, the determination of IgM antibodies for HCMV is not helpful in identifying patients at risk or in following the course of HCMV disease because antibody response is too slow and it has low sensitivity

A study of some viral pathogens in infants and children with lowe respiratory tract infection and attending the intensive care unit

Acute lower respiratory tract infections are the most common illness in pediatrics. A great variety of viruses especially RSV can cause bronchopneumonia and bronchiolitis in infants and children. This work aimed to evaluate some viral pathogens in pneumonia and bronchiolitis in infants and children admitted to the ICU. This study included 142 patients, 70 suffered bronchopneumonia and 72 suffered bronchiolitis admitted to the ICU in Assiut Pediatric University Hospital, Egypt. The study was done from November 2002 to February 2003 and from the period of November 2003 to February 2004. Clinical evaluation, chest x-ray, complete blood count and arterial blood gases as well as endotracheal suction for collection of the samples for viral study and bacterial cultures were done. Regarding viral tissue culture 66 patients were positive to the studied viruses [26 with bronchopneumonia and 40 with bronchiolitis] with male predominance [43 males with 65.1%]. Out of the 66, 48 were below age of 12 months, 12 were below age of 24 months and 6 were below 36 months. Respiratory Synsytial virus [RSV] was found in 32 cases [484%], influenza A was in 12 [18.1%], Parainfluenza 3 in 18[27.2%], Parainfluenza I in 4 [6%] and adenovirus in 4 [6%]. It was noticed that there were positive bacterial cultures in 27 cases and also mixed viral types. Malnutrition especially the severe type was concomitant with viral infection specially RSV, As regards the blood gases and respiratory rate it was found that cases with bronchiolitis showed significant differences than those of bronchopneumonia where bronchiolitis was more severe than bronchopneumonia. There were 76 cases negative to the studied viruses 44 were bronchopneumonia and 32 were bronchiolitis. Bacterial cultures were positive in 25 patients. Analysis of the blood count showed leucocytosis in the cases as a whole with significant higher levels in the cases with positive bacterial cultures than those with viral infection only. Lymphocytes were significantly higher in the cases with positive viral cultures than those negative to these cultures and eosinophils were significantly higher in the cases negative to the studied viruses and also showed negative bacterial cultures that the cause could be due to allergic conditions. As regards the outcome of the cases that were positive to the studied viruses 29 died [43.9%], 20 of them were due to RSV infection. It is concluded that RSV is the commonest cause of viral lower respiratory tract infection in infants and children. Mixed viral and bacterial infection is not uncommon which is strongly concomitant with the immunocompromised patients' especially malnourished cases. So the use of immunostimulants in addition to antimicrobial and antiviral drugs may be beneficial in such cases