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[Comparative efficacy of laboratory methods for cytomegalovirus detection in autopsy material]
A A Medzhidova1, L L Nisevich, N E Fedorova
1Ivanovsky Research Institute of Virology, Research Institute of Pediatrics, Research Institute of Phisiko-Chemical Medicine, Research and Production Firm Litekh, Morozovskaya Children's Clinical Hospital, Moscow, Russia.
Abstract:
Eighty eight autopsy specimens obtained from 30 fetuses, still-borns and infants died during the first year of life, all suspected for congenital virus infection at postmortem examination, were studied. The specimens were analyzed by 3 techniques: rapid culture method (RCM) for detection of cytomegalovirus (CMV) infectious activity, the immunocytochemical method for detection of CMV antigen in prints of organs and polymerase chain reaction (PCR) for detection CMV DNA. CMV was detected in 16 out of 26 specimens (61.5%) by PCR, in 43 out of 88 specimens (49%) by RCM and in 15 out of 64 specimens (23%) in prints. The comparison of immune reagents revealed that monoclonal antibodies (McAb) were more specific than polyclonal serum antibodies, as the latter yielded the positive reaction in 10 out of 26 cases (38%), found to be negative in PCR. The data thus obtained indicate that complex techniques, including PCR and RCM in combination with McAb, should be used for evaluation of CMV infection role in child mortality.
Insights
Cytomegalovirus (CMV) infection is a significant concern in infant mortality. Combining Polymerase Chain Reaction (PCR) and rapid culture methods (RCM) with monoclonal antibodies (McAb) offers the most effective diagnostic approach for evaluating CMV
Area of Science:
- Virology
- Pathology
- Pediatrics
Background:
- Congenital cytomegalovirus (CMV) infection is a leading cause of non-genetic sensorineural hearing loss and developmental disabilities.
- Accurate diagnosis of CMV infection in perinatal deaths is crucial for understanding its role in child mortality.
- Existing diagnostic methods vary in sensitivity and specificity, necessitating a comparative analysis.
Purpose of the Study:
- To evaluate and compare the efficacy of three diagnostic techniques for detecting cytomegalovirus (CMV) in autopsy specimens from infants.
- To determine the most reliable method for assessing the contribution of CMV infection to infant mortality.
- To compare the specificity of monoclonal antibodies (McAb) versus polyclonal serum antibodies in immunocytochemical detection of CMV.
Main Methods:
- Eighty-eight autopsy specimens from fetuses, stillborns, and infants up to one year of age, suspected of congenital virus infection, were analyzed.
- Techniques employed included: rapid culture method (RCM) for CMV infectious activity, immunocytochemistry for CMV antigen detection in organ prints, and polymerase chain reaction (PCR) for CMV DNA detection.
- Comparison of monoclonal antibodies (McAb) and polyclonal serum antibodies was performed for immunocytochemical analysis.
Main Results:
- Polymerase chain reaction (PCR) detected CMV in 61.5% (16/26) of specimens, while RCM detected it in 49% (43/88).
- Immunocytochemistry on organ prints detected CMV in 23% (15/64) of specimens.
- Monoclonal antibodies (McAb) demonstrated higher specificity than polyclonal antibodies, with polyclonal antibodies showing false positives in 38% (10/26) of cases negative by PCR.
Conclusions:
- Polymerase chain reaction (PCR) and rapid culture method (RCM) are highly sensitive techniques for CMV detection in infant autopsy samples.
- The combination of PCR and RCM, particularly when utilizing monoclonal antibodies (McAb) for immunocytochemistry, provides a robust approach for diagnosing CMV infection.
- These comprehensive diagnostic strategies are essential for accurately evaluating the role of CMV infection in perinatal and infant mortality.