USE OF VIRAL CULTURES AND SEROLOGIC TESTS FOR CYTOMEGALOVIRUS-INFECTION - RATIONAL OR RANDOM

To assess their applied clinical utility, viral cultures and serologic al tests for cytomegalovirus (CMV) were reviewed at Duke University Me dical Center (DUMC), a 1,125-bed tertiary-care hospital. Less than 1% (3 of 1,216) of CMV cultures were positive, and 8% of serum samples (3 5 of 587) were positive by single sera IgM ELISA. Sixteen percent (32 of 199) of IgG acute to convalescent sera pairs were positive. Four hu ndred five of 588 (69%) serum samples were positive for the IgM/IgG pa ssive latex agglutination test, consistent with the results for random blood donors. Review of hospital records showed that fewer than 1% of the positive-test patients (excluding the lates test) received treatm ent for CMV. Comparisons of tests ordered on individual patients did n ot disclose a coherent diagnostic strategy. Tile authors conclude that the majority of testing for CMV in their medical center does not yiel d useful clinical information, but carries a substantial financial bur den, A nerv diagnostic strategy to attempt to diagnose CMV disease is needed.