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Open Access Research article

Urine real-time polymerase chain reaction detection for children virus pneumonia with acute human cytomegalovirus infection

Zhidai Liu145, Penghui Zhang245, Shi Tang145, Xiaoyan He145, Rong Zhang145, Xinbin Wang145, Zhaojian Yuan145, Junjie Tan145, Bin Peng6, Enmei Liu345, Zhou Fu345 and Lin Zou145*

Author Affiliations

1 Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China

2 Center for Clinical Laboratory, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China

3 Department of Respiratory Medicine, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China

4 Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China

5 Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China

6 Department of Health Statistics, School of Public Health, Chongqing Medical University, Yuzhong District, Chongqing, China

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BMC Infectious Diseases 2014, 14:245  doi:10.1186/1471-2334-14-245

Published: 8 May 2014

Abstract

Background

Human cytomegalovirus (HCMV) is an important pathogen of viral pneumonia in children. The diagnosis of acute HCMV infection is complicated and difficult.

Methods

Clinical 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.

Results

The 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%).

Conclusions

Our 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.

Keywords:
Human cytomegalovirus; Children; Pneumonia; Urine sample; pp65 gene