López M, Paz I, Pedraza M A, Lumbreras C, Otero J R
Unidad de Virología, Hospital 12 de Octubre, Madrid.
Enferm Infecc Microbiol Clin. 1992 Aug-Sep;10(7):409-12.
We have evaluated the microbiologic output and clinical significance of the detection of cytomegalovirus in 111 bronchoalveolar lavage specimens from immunosuppressed patients with pneumonitis. The samples were simultaneously processed by conventional tube culture and the rapid shell-vial centrifugation culture assay. Cytomegalovirus was recovered from 30 specimens (27%). The rapid shell-vial procedure was more sensitive than the tube culture, but in two cases cytomegalovirus was isolated only in tube cultures. Cytomegalovirus was considered clinically significant in only 3 from 13 HIV positive patients. All culture positive, HIV negative patients received treatment with ganciclovir. However, ganciclovir was never used on culture negative, HIV negative patients and cytomegalovirus related morbi-mortality was not found in these patients. A prospective study is needed to conclude if a cytomegalovirus negative culture also has a treatment exclusion value in HIV positive patients.
我们评估了111份免疫抑制性肺炎患者支气管肺泡灌洗标本中巨细胞病毒检测的微生物学结果及临床意义。样本同时采用传统试管培养法和快速空斑离心培养法进行处理。30份标本（27%）中检出巨细胞病毒。快速空斑离心法比试管培养法更敏感，但有2例巨细胞病毒仅在试管培养中分离出来。13例HIV阳性患者中仅3例的巨细胞病毒被认为具有临床意义。所有培养阳性的HIV阴性患者均接受了更昔洛韦治疗。然而，培养阴性的HIV阴性患者从未使用过更昔洛韦，且未在这些患者中发现与巨细胞病毒相关的病死情况。需要进行一项前瞻性研究，以确定巨细胞病毒培养阴性对HIV阳性患者是否也具有排除治疗的价值。
