Mj. Miller et al., APPLICATION OF PCR TO MULTIPLE SPECIMEN TYPES FOR DIAGNOSIS OF CYTOMEGALOVIRUS-INFECTION - COMPARISON WITH CELL-CULTURE AND SHELL VIAL ASSAY, Journal of clinical microbiology, 32(1), 1994, pp. 5-10
Human cytomegalovirus (CMV) is a herpesvirus that is responsible for s
ignificant morbidity and mortality in congenitally infected infants an
d immunocompromised patients. Antiviral therapies are available, thus
making timely diagnosis of significant importance to at-risk patients.
A PCR system was devised. The newly devised system, unlike previously
described systems, can be applied to a wide variety of specimen types
in a clinical microbiology laboratory setting. Specimens from all sit
es routinely accepted for CMV culture were shown to be acceptable for
CMV PCR. Sensitivity and specificity were established in comparison wi
th those of both monolayer culture and shell vial assay (SVA). The sen
sitivity and specificity of PCR for detection of CMV in specimens excl
usive of urine and blood were 97.5 (77 of 79 specimens) and 87.2% (41
of 47 specimens), respectively. The sensitivity and specificity of PCR
for urine and blood specimens were 100 (10 of 10) and 95.7% (45 of 47
) and 66.7 (4 of 6) and 78.8% (41 of 52), respectively. Discrepancies
of positive PCR results with negative culture or SVA results occurred
for specimens flanked chronologically by other culture- or SVA-positiv
e specimens and were likely culture failures, increasing the specifici
ty (100%) of PCR. Discrepancies of negative PCR results with positive
culture or SVA results occurred in specimens with few cells or infecti
ous foci by SVA or culture and may represent sampling variability asso
ciated with low vims titers.