POLYMERASE CHAIN-REACTION FOR RAPID DETECTION OF OCULAR ADENOVIRUS INFECTION

Adenoviruses are associated with endemic and epidemic acute conjunctiv itis, large nosocomial outbreaks reflecting virus transmission on unwa shed hands or inadequately sterilised ophthalmic instruments. The poly merase chain reaction (PCR) proved more sensitive than antigen detecti on by immune dot-blot test for the rapid diagnosis of ocular adenoviru s infection (sensitivities in a retrospective study 112/123 (91%) vers us 72/123 (59%), P < 0.001). Indeed, in a prospective comparison, DNA amplification and virus isolation generated similar numbers of positiv e results (34 versus 32), though five PCR positive results were possib ly false positives. The sensitivity of the PCR was largely independent of adenovirus subgenus or serotype, though reduced sensitivity with s ubgenus B strains could not be excluded. Specimen preparation for DNA amplification using a simple lysis buffer proved more effective than p henol-chloroform extraction. The immune dot-blot test gave unavoidable false positive results, but with the PCR this problem could be minimi zed by technical modifications. The PCR could replace antigen detectio n and virus isolation as the initial test for adenoviruses in conjunct ival swabs, with cell culture only being retained for adenovirus serot yping in PCR positive specimens and for other viruses such as herpes s implex. (C) 1995 Wiley-Liss, Inc.