先天性巨细胞病毒感染中的混合感染和毒株多样性。
Mixed infection and strain diversity in congenital cytomegalovirus infection.
机构信息
Department of Pediatrics, University of Alabama, Birmingham, AL 35233, USA.
出版信息
J Infect Dis. 2011 Oct 1;204(7):1003-7. doi: 10.1093/infdis/jir457.
BACKGROUND
Cytomegalovirus (CMV), the most common cause of congenital infection, exhibits extensive genetic variability. We sought to determine whether multiple CMV strains can be transmitted to the fetus and to describe the distribution of genotypes in the saliva, urine, and blood.
METHODS
Study subjects consisted of a convenience sampling of 28 infants found to be CMV-positive on newborn screening as part of an ongoing study. Genotyping was performed on saliva specimens obtained during newborn screening and urine, saliva, and blood obtained at a later time point within the first 3 weeks of life.
RESULTS
Six (21.4%) of the 28 saliva samples obtained within the first 2 days of life contained >1 CMV genotype. Multiple CMV genotypes were found in 39% (5/13) of urine, saliva, and blood samples obtained within the first 3 weeks of life from 13 of the 28 newborns. There was no predominance of a CMV genotype at a specific site; however, 4 infants demonstrated distinct CMV strains in different compartments.
CONCLUSIONS
Infection with multiple CMV strains occurs in infants with congenital CMV infection. The impact of intrauterine infection with multiple virus strains on the pathogenesis and long-term outcome remains to be elucidated.
背景
巨细胞病毒（CMV）是最常见的先天性感染病原体，具有广泛的遗传变异性。我们旨在确定是否可以将多种 CMV 株传播给胎儿，并描述唾液、尿液和血液中的基因型分布。
方法
研究对象是 28 名在新生儿筛查中发现 CMV 阳性的婴儿，这是一项正在进行的研究的一部分。在新生儿筛查期间获得唾液样本，并在生命的前 3 周内的稍后时间点获得尿液、唾液和血液样本，对这些样本进行基因分型。
结果
在生命的头 2 天内获得的 28 份唾液样本中，有 6 份（21.4%）含有 >1 种 CMV 基因型。在 28 名新生儿中的 13 名在生命的前 3 周内获得的尿液、唾液和血液样本中，有 39%（5/13）发现了多种 CMV 基因型。特定部位没有 CMV 基因型的优势；然而，4 名婴儿在不同部位显示出不同的 CMV 株。
结论
在患有先天性 CMV 感染的婴儿中，会感染多种 CMV 株。宫内感染多种病毒株对发病机制和长期结局的影响仍有待阐明。
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