Detection of cytomegalovirus in bronchoalveolar lavage fluid from immunocompromised patients with pneumonitis by viral culture and DNA quantification
Por:
Berengua, C, Miro, E, Gutierrez, C, Sanchez, M, Mulero, A, Ramos, P, del Cuerpo, M, Torrego, A, Garcia-Cadenas, I, Pajares, V, Navarro, F, Martino, R, Rabella, N
Publicada:
1 jul 2023
Ahead of Print:
1 may 2023
Resumen:
Purpose: To compare the detection of human cytomegalovirus (HCMV) in bronchoalveolar lavage (BAL) fluid by viral culture and quantitative polymerase chain reaction (qPCR), and to establish a viral load threshold that can identify cases of HCMV replication indicative of pneumonitis. There is currently no universal viral load cut-off to differentiate between patients with and without pneumonitis, and the interpretation of qPCR results is challenging.Methods: 176 consecutive BAL samples from immunosuppressed hosts with signs and/or symptoms of respiratory infection were prospectively studied by viral culture and qPCR.Results: Concordant results were obtained in 81.25% of the BAL samples. The rest were discordant, as only 34% of the qPCR-positive BAL samples were positive by culture. The median HCMV load was significantly higher in culture-positive than in culture-negative BAL samples (5038 vs 178 IU/mL). Using a cut-off value of 1258 IU/mL of HCMV in BAL, pneumonia was diagnosed with a sensitivity of 76%, a specificity of 100%, a VPP of 100% and VPN of 98%, and HCMV was isolated in 100% of the BAL cultures.Conclusion: We found that a qPCR-negative was a quick and reliable way of ruling out HCMV pneumonitis, but a positive result did not always indicate clinically significant replication in the lung. However, an HCMV load in BAL fluid of >= 1258 IU/mL was always associated with disease, whereas < 200 IU/mL rarely so.
Filiaciones:
Berengua, C:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Miro, E:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Gutierrez, C:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
Sanchez, M:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
Mulero, A:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
Ramos, P:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
del Cuerpo, M:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
Torrego, A:
Hosp Santa Creu & Sant Pau, Pneumol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Garcia-Cadenas, I:
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Hematol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Pajares, V:
Hosp Santa Creu & Sant Pau, Pneumol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Navarro, F:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Martino, R:
Hosp Santa Creu & Sant Pau, Microbiol Dept, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Hematol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Rabella, N:
Univ Autonoma Barcelona, Genet & Microbiol Dept, Barcelona, Spain
St Pau Inst Biomed Res IIb St Pau, Barcelona, Spain
Green Submitted, hybrid, All Open Access, Hybrid Gold
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