Lipson S M, Kaplan M H, Tseng L F, Mandel F S
Jane and Dayton Brown and Dayton T. Brown, Jr., Virology Laboratory, Department of Medicine, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
Can J Microbiol. 1993 Nov;39(11):1059-65. doi: 10.1139/m93-160.
Direct specimen testing was performed on 186 peripheral blood specimens to identify the presence of antigen to cytomegalovirus (viz., the cytomegalovirus antigenemia (CMV-Ag) assay). Confirmatory testing was performed using the shell vial indirect immunofluorescence assay (SVA-IFA), the indirect immunoperoxidase assay (TC-IPA), and conventional tube culture isolation (TC-CPE). The primary reagent for the CMV-Ag assay consisted of anti-CMV monoclonal antibody directed against the internal matrix structural phosphoprotein (1C3; Clonatec-Biosoft, France). The 72-kDa early nuclear antigen (Dupont) was utilized in the SVA-IFA and the TC-IPA. All test systems received an equal number of polymorphonuclear leukocytes in the inoculum. CMV was detected and isolated from 30% (55/186) of the specimens evaluated by either one or a combination of the tests. Detection and (or) isolation of CMV from blood by the CMV-Ag assay, SV-IFA, TC-IPA, and TC-CPE occurred at a rate of 17 (31/186), 12 (22/186), 16 (29/186), and 26% (49/186). Three of 55 positive specimens were identified only by the CMV-Ag assay; each patient in question, however, had at least one previous CMV isolate. No significant differences in sensitivity occurred between the CMV-Ag assay, the SVA-IFA, or the TC-IPA. However, TC-CPE including the blind passage of all negative tube cultures yielded a significantly larger number of positive blood specimens than either of the rapid detection methodologies. The CMV-Ag assay encompasses the benefits of a nonculture system, is simple to perform and easy to read, permits a same-day diagnosis, and requires less reagents than the routinely used SVA-IFA or TC-IPA.(ABSTRACT TRUNCATED AT 250 WORDS)
对186份外周血标本进行直接标本检测，以确定是否存在巨细胞病毒抗原（即巨细胞病毒抗原血症（CMV-Ag）检测）。采用空斑小管间接免疫荧光测定法（SVA-IFA）、间接免疫过氧化物酶测定法（TC-IPA）和传统试管培养分离法（TC-CPE）进行确证检测。CMV-Ag检测的主要试剂为由针对内部基质结构磷蛋白的抗CMV单克隆抗体组成（1C3；Clonatec-Biosoft，法国）。72-kDa早期核抗原（杜邦公司）用于SVA-IFA和TC-IPA。所有检测系统在接种物中接受等量的多形核白细胞。通过一种或多种检测方法评估的标本中，有30%（55/186）检测到并分离出CMV。通过CMV-Ag检测、SV-IFA、TC-IPA和TC-CPE从血液中检测和（或）分离出CMV的发生率分别为17%（31/186）、12%（22/186）、16%（29/186）和26%（49/186）。55份阳性标本中有3份仅通过CMV-Ag检测鉴定出来；然而，每例相关患者之前至少有一次CMV分离株。CMV-Ag检测、SVA-IFA或TC-IPA之间在敏感性上没有显著差异。然而，包括对所有阴性试管培养物进行盲传的TC-CPE产生的阳性血液标本数量明显多于任何一种快速检测方法。CMV-Ag检测具有非培养系统的优点，操作简单、易于判读，可当日诊断，且所需试剂比常规使用的SVA-IFA或TC-IPA少。（摘要截短于250字）
