Department of Clinical Laboratory Medicine, The People Hospital of Qingyang City, Qingyang, China.
Department of Infectious Disease, The People Hospital of Qingyang City, Qingyang, China.
J Clin Lab Anal. 2020 Feb;34(2):e23199. doi: 10.1002/jcla.23199. Epub 2020 Jan 29.
Our objective was to evaluate the prevalence and different diagnostic methods of breastmilk (BM)-acquired cytomegalovirus (CMV) infection in a pathologically jaundiced cohort.
A total of 400 infants confirmed with pathological jaundice at The People's Hospital of Qingyang City were screened for BM-acquired CMV infection between February 2018 and February 2019. A total of 300 infants were finally enrolled in our study. CMV infection was confirmed by detecting both CMV-DNA in various samples using FQ-PCR and CMV-IgM with chemiluminescence. Clinical and other laboratory data were collected from these infants during their hospitalization or regular visits.
Ninety-eight (32.67%) subjects were confirmed to be BM CMV-DNA-positive, and 18 (18.37%) were diagnosed with a BM-acquired CMV infection. All 18 (100%) infants with a BM-acquired CMV infection were CMV-DNA-positive in urine, while 5 (27.78%) cases and 11 (61.11%) cases were confirmed in plasma and peripheral blood mononuclear cells (PBMCs), respectively. Only 6 (33.33%) infants were CMV-IgM-positive. Birthweight, direct bilirubin, aspartate aminotransferase, and the viral load in BM of the BM-acquired CMV group were higher than those in the non-infected group (P < .05). Low birthweight and viral load in BM were risk factors for BM-acquired CMV infection. Detecting CMV-DNA in urine samples exhibited better performance than the other methods for screening BM-acquired CMV infections.
Our study found a high prevalence of BM-acquired CMV infection in jaundiced infants, and detecting CMV-DNA in a urine sample was the most sensitive method for disease screening.
本研究旨在评估病理性黄疸患儿母乳（BM）获得性巨细胞病毒（CMV）感染的流行率和不同诊断方法。
2018 年 2 月至 2019 年 2 月，对庆阳市人民医院收治的 400 例病理性黄疸患儿进行筛查，以确定是否存在 BM 获得性 CMV 感染。最终共有 300 例患儿纳入本研究。采用荧光定量聚合酶链反应（FQ-PCR）检测各种样本中的 CMV-DNA，以及化学发光法检测 CMV-IgM，从而确定 CMV 感染。收集这些患儿住院期间或定期随访时的临床及其他实验室数据。
98 例（32.67%）患儿的 BM 中 CMV-DNA 阳性，18 例（18.37%）患儿被诊断为 BM 获得性 CMV 感染。所有 18 例（100%）BM 获得性 CMV 感染患儿的尿液中均 CMV-DNA 阳性，而在血浆和外周血单个核细胞（PBMC）中分别有 5 例（27.78%）和 11 例（61.11%）患儿的检测结果呈阳性。仅有 6 例（33.33%）患儿的 CMV-IgM 阳性。BM 获得性 CMV 组的出生体重、直接胆红素、天门冬氨酸氨基转移酶和 BM 中的病毒载量均高于未感染组（P<0.05）。低出生体重和 BM 中的病毒载量是 BM 获得性 CMV 感染的危险因素。检测尿液样本中的 CMV-DNA 对于筛查 BM 获得性 CMV 感染的表现优于其他方法。
本研究发现，黄疸患儿中 BM 获得性 CMV 感染的流行率较高，检测尿液样本中的 CMV-DNA 是最敏感的疾病筛查方法。
