Abstract
BackgroundHuman cytomegalovirus (HCMV) is an important pathogen of viral pneumonia in children. The diagnosis of acute HCMV infection is complicated and difficult.MethodsClinical and laboratory data of 6063 hospitalized children with respiratory infection and 509 with respiratory virus infection alone were retrospectively analyzed. Urine and respiratory specimens of 186 hospitalized children with pneumonia were also prospectively collected. Real-time polymerase chain reaction (PCR) and a chemiluminescent assay were used to detect HCMV DNA copy number, the pp65 gene, and HCMV IgM.ResultsThe patients with respiratory virus infection alone and those with pulmonary HCMV infection (n = 422) were mostly children aged <6 months old (82.91%, 422/509). The accuracy of urine HCMV DNA (82.32%) was higher than that of HCMV IgM (67.78%), indicating that PCR of urine samples is suitable for determining pediatric acute pulmonary HCMV infection. There was no significant difference in detecting HCMV DNA or the pp65 gene between urinary and respiratory specimens (P > 0.05) in 186 pediatric pneumonia cases. The accuracy of the pp65 gene measured in urine for determining acute pulmonary HCMV infection was the highest (93.01%).ConclusionsOur study shows a novel method for investigating acute pulmonary HCMV infection in children by using real-time PCR and non-invasive samples. This study also highlights the superiority and potential use of the pp65 gene as an important target for the diagnosis of acute pulmonary HCMV infection.
Highlights
Human cytomegalovirus (HCMV) is an important pathogen of viral pneumonia in children
There were no significant differences in the general characteristics of children with respiratory infection, including the odds ratio of HCMV infection in different sex groups, the percentage of patients with positive clinical manifestations, the duration of different types of pneumonia, and the incidence rate of severe pneumonia among different groups (Additional file 1: Tables S4–S6)
In summary, we provide a better understanding on the incidence, and clinical and laboratory characteristics of acute HCMV infection in pediatric pneumonia
Summary
Human cytomegalovirus (HCMV) is an important pathogen of viral pneumonia in children. Several laboratory tests are applied to help with diagnosis of HCMV infection, including viral isolation and culture, serology, CMV inclusion body detection, and molecularbased assays. The gold standard for diagnosis of HCMV infection is viral isolation and culture, but the requirements for this procedure are too great for popular use in clinical practice [4,5]. Serological assays and polymerase chain reaction (PCR) are the main methods for detecting HCMV infection. There are few reports on the relationship between real-time PCR results and clinical diagnosis for HCMV related to pneumonia in the pediatric population. The best sample for detecting HCMV pneumonia by real-time PCR is a respiratory specimen [sputum or bronchoalveolar lavage fluid (BALF)], collecting serological specimens by an invasive procedure and respiratory specimens is difficult for children, especially those younger than 1 year old. Measuring pulmonary HCMV infection by using noninvasive samples (e.g., urine) would be helpful
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