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Journal of Clinical Microbiology, November 2002, p. 4203-4206, Vol. 40, No. 11
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.11.4203-4206.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Molecular Methods for Cytomegalovirus Surveillance in Bone Marrow Transplant Recipients

Departments of Pediatrics,¹ Medicine, University of Colorado,² The Children's Hospital, Denver, Colorado³

Received 29 May 2002/ Returned for modification 29 July 2002/ Accepted 26 August 2002

Two different methods for detection of cytomegalovirus (CMV), PCR and hybrid capture (HC), were compared by using plasma, peripheral blood leukocytes (PBLs), and whole blood (WB) from allogeneic bone marrow transplant recipients. One hundred specimens were obtained from nine children over an 18-month surveillance period. PCR of plasma for CMV was used for clinical management. The proportions of samples positive for CMV DNA by PCR with plasma, HC with WB, and PCR with PBLs were 21, 28, and 37%, respectively. Among 44 samples that were tested by all three methods, 68% had concordant results. By using a robust definition of true-positive samples (positivity by two or more methods or positivity of sequential samples by one method), the sensitivities of PCR with plasma, HC with WB, and PCR with PBLs were 50, 67, and 83%, respectively, and the specificities were 100, 96, and 96%, respectively. Two patients developed CMV-associated end-organ disease (one developed respiratory disease, and one developed gastrointestinal disease). CMV DNA was not detected in the plasma 1 week prior to the development of symptoms in either patient, whereas HC with WB was positive for both patients and PCR with PBLs was for one patient. These data suggest that WB or PBLs might be the preferred sample for use for surveillance for CMV in immunocompromised patients.

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