Günlemez Ayla, Kolaylı Fetiye, Yazıcı Özçelik Eda, Duranoğlu Ali, Durgut Merve, Arısoy Emin Sami, Kara Bülent
Division of Newborn Diseases, Department of Pediatrics, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Department of Microbiology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Turk Arch Pediatr. 2023 Jul;58(4):371-375. doi: 10.5152/TurkArchPediatr.2023.22309.
Congenital cytomegalovirus infection is the most common congenital infection. Although screening of congenital cytomegalovirus infection with polymerase chain reaction studies in blood, urine, and saliva samples has been developed in recent years, it is not yet in routine use in any country.
In our study, cytomegalovirus deoxyribonucleic acid analysis was per- formed by real-time polymerase chain reaction method in saliva samples taken before the first feeding during the first day following birth in neonates born in a university hospital between January 2021 and January 2022. To support the diagnosis, additionally, cytomegalovirus deoxy- ribonucleic acid positivity in urine and blood samples was investigated in newborns with cyto- megalovirus deoxyribonucleic acid positivity in saliva.
Cytomegalovirus deoxyribonucleic acid was investigated in saliva samples of 545 neonates by real-time polymerase chain reaction method in 1-year period and positiv- ity was found in 6 neonates. Since cytomegalovirus deoxyribonucleic acid was found nega- tive by the real-time polymerase chain reaction method in the urine and blood samples of 5 of these neonates, the positivity in the saliva sample was interpreted as false positivity. In 1 case, cytomegalovirus deoxyribonucleic acid positivity was detected in urine and blood samples 5 weeks later. As a result, definite congenital cytomegalovirus infection could not be diagnosed in 545 cases, while possible congenital cytomegalovirus infection was diag- nosed in 1 case.
It has been concluded that the frequency of congenital cytomegalovirus infection is low in our study group and studying saliva samples showed high false-positive rates. It is seen that saliva is not a suitable sample for detecting cytomegalovirus deoxyribonucleic acid by real-time polymerase chain reaction method.
先天性巨细胞病毒感染是最常见的先天性感染。尽管近年来已开发出通过聚合酶链反应研究血液、尿液和唾液样本筛查先天性巨细胞病毒感染的方法，但尚未在任何国家常规使用。
在我们的研究中，对2021年1月至2022年1月在某大学医院出生的新生儿出生后第一天首次喂食前采集的唾液样本，采用实时聚合酶链反应法进行巨细胞病毒脱氧核糖核酸分析。此外，为支持诊断，对唾液中巨细胞病毒脱氧核糖核酸呈阳性的新生儿的尿液和血液样本中的巨细胞病毒脱氧核糖核酸阳性情况进行了调查。
在1年时间里，采用实时聚合酶链反应法对545例新生儿的唾液样本进行了巨细胞病毒脱氧核糖核酸检测，其中6例呈阳性。由于其中5例新生儿的尿液和血液样本通过实时聚合酶链反应法检测巨细胞病毒脱氧核糖核酸为阴性，因此唾液样本中的阳性结果被解释为假阳性。在1例中，5周后在尿液和血液样本中检测到巨细胞病毒脱氧核糖核酸阳性。结果，545例中无法确诊为明确的先天性巨细胞病毒感染，而1例被诊断为可能的先天性巨细胞病毒感染。
得出结论，我们的研究组中先天性巨细胞病毒感染的发生率较低，且研究唾液样本显示假阳性率较高。可见唾液不是通过实时聚合酶链反应法检测巨细胞病毒脱氧核糖核酸的合适样本。
