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评价伊斯坦布尔一所大学医院收治的孕妇的先天性巨细胞病毒感染。

Evaluation of Congenital Cytomegalovirus Infection in Pregnant Women Admitted to a University Hospital in Istanbul.

机构信息

Department of Medical Microbiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul 34093, Turkey.

Institute of Health Sciences, Istanbul University, Istanbul 34126, Turkey.

出版信息

Viruses. 2024 Mar 8;16(3):414. doi: 10.3390/v16030414.

Abstract

Cytomegalovirus (CMV) can cause serious complications in immunocompromised individuals and fetuses with congenital infections. These can include neurodevelopmental impairments and congenital abnormalities in newborns. This paper emphasizes the importance of concurrently evaluating ultrasonography findings and laboratory parameters in diagnosing congenital CMV infection. To examine the prenatal characteristics of CMV DNA-positive patients, we assessed serum and amniotic fluid from 141 pregnant women aged 19-45 years, each with fetal anomalies. ELISA and PCR tests, conducted in response to these amniocentesis findings, were performed at an average gestational age of 25 weeks. Serological tests revealed that all 141 women were CMV IgG-positive, and 2 (1.41%) had low-avidity CMV IgG, suggesting a recent infection. CMV DNA was detected in 17 (12.05%) amniotic fluid samples using quantitative PCR. Of these, 82% exhibited central nervous system abnormalities. Given that most infections in pregnant women are undetectable and indicators non-specific, diagnosing primary CMV in pregnant women using clinical findings alone is challenging. We contend that serological tests should not be the sole means of diagnosing congenital CMV infection during pregnancy.

摘要

巨细胞病毒 (CMV) 可导致免疫功能低下个体和先天性感染的胎儿出现严重并发症。这些并发症包括新生儿的神经发育障碍和先天性异常。本文强调了在诊断先天性 CMV 感染时同时评估超声检查结果和实验室参数的重要性。为了研究 CMV DNA 阳性患者的产前特征,我们评估了 141 名年龄在 19-45 岁之间、每个胎儿都有异常的孕妇的血清和羊水。根据这些羊水穿刺检查结果,在平均妊娠 25 周时进行了 ELISA 和 PCR 检测。血清学检测显示,141 名妇女的 CMV IgG 均为阳性,其中 2 名(1.41%)的 CMV IgG 低亲和力,提示近期感染。使用定量 PCR 在 17 份(12.05%)羊水样本中检测到 CMV DNA。其中,82%存在中枢神经系统异常。鉴于孕妇大多数感染无法检测到且指标不具有特异性,仅依靠临床发现诊断孕妇原发性 CMV 感染具有挑战性。我们认为,血清学检测不应是妊娠期间诊断先天性 CMV 感染的唯一方法。

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