The study of detection methods of cytomegalovirus infection in newborns / 中国小儿急救医学

ABSTRACT

Objective To evaluate the diagnostic value of fluorescent quantitative polymerase chain reaction(FQ-PCR) assay in human cytomegalovirus (HCMV) infection by detecting quantitatively HCMV DNA in peripheral blood mononuclear cell ( PBMC) of newborns,to evaluate the choice of detection methods for neonatal HCMV infection,and to provide a reasonable diagnosis basis for the clinic. Methods The urina-ry HCMV-DNA levels in 102 neonates with suspected HCMV infection were detected by FQ-PCR. The HCMV-DNA in PBMC was detected by FQ-PCR,and serum HCMV-IgM antibody was detected by chemilu-minescence immunoassay ( CLIA) . Then the sensitivity, specificity, coincidence rate and other indicators in the three kinds of detection methods were compared. Results Among 102 cases of suspected HCMV-infec-ted newborns,56 cases were symptomatic and 46 cases were non-symptomatic. The positive rate of HCMV-DNA in urine[87. 3％(89/102)] was significantly higher than that of PBMC HCMV-DNA [58. 8％ (60/102)] and serum HCMV-IgM antibody [40. 2％ (41/102)](all P<0. 01). For symptomatic HCMV-infec-ted newborns, PBMC HCMV-DNA quantitative detection sensitivity ( 71. 4％) was higher than serum HCMV-IgM antibody (57. 1％), and the specificity (56. 5％) was higher than urine HCMV-DNA quantifi-cation (8. 7％). The area under receiver operating characteristic(ROC) curve of PBMC HCMV-DNA quan-tification and HCMV-IgM antibody detection were 0. 642 (P=0. 014) and 0. 659 (P=0. 006),respectively;therefore PBMC HCMV-DNA and HCMV-IgM antibodies were of great importance in diagnosing symptom-atic HCMV infection in neonates. The area under the ROC curve of urinary HCMV-DNA quantification was 0. 461 ( P =0. 496 ) , and there was no significant difference between symptomatic and non-symptomatic HCMV infections in neonates. Conclusion HCMV-DNA detection in PBMC has higher sensitivity compared with HCMV-DNA detection in urine and higher specificity compared with IgM antibody detection in serum. It can be used to detect the early infection of HCMV in newborns. The rate of detection of HCMV infection can be improved by combination of the three methods.