Rapid Diagnosis of Cytomegalovirus Infection in Immunocompromised Patients by Detection of Early Antigen Fluorescent Foci

Griffiths, Paul; Stirk, P. R.; Ganczakowski, M; Panjwani, D.; Ball, Mog; Blacklock, Hilary; Prentice, H. G.

doi:10.1016/s0140-6736(84)92797-1

Cited by 215 publications

(71 citation statements)

References 21 publications

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“…Another one was a CMV-positive specimen which had been stored at -70 C for more than two years. Therefore, HRP-C7 staining probably detected defective virus in this case as described by Griffiths et al (9). The last one was the oral swab concurrently infected by HSV-1 which destroyed the cells rapidly.…”

supporting

confidence: 59%

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Rapid Diagnosis of Cytomegalovirus Infections by Direct Immunoperoxidase Staining with Human Monoclonal Antibody against an Immediate‐Early Antigen

Eizuru

Minematsu

Minamishima

et al. 1991

Microbiology and Immunology

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Direct immunoperoxidase technique using a horseradish peroxidase (HRP)-conjugated Fab' fragment of human monoclonal antibody (humab C7), designated HRP-C7, was evaluated as a rapid diagnosis of cytomegalovirus (CMV) infection. A total of 138 clinical specimens consisting of 124 urine samples and 14 oral swabs were examined for CMV by the direct HRP-C7 staining in comparison with conventional virus isolation. The number of CMV-positive samples by each method was 40 (29.0%) for the former and 37 (26.8%) for the latter, respectively. By HRP-C7 staining, CMV was identifiable within 24 hr after inoculation. By conventional isolation method, an average of 10.3 days had passed before cytopathic effect characteristic of CMV appeared in the cell culture. Some false-positive and false-negative cases were discussed in relation to toxicity of urine samples, storage of the samples, and amount of CMV in the sample. The sensitivity and specificity of HRP-C7 method against conventional isolation method were 89.2% and 93.1%, respectively. Thus, HRP-C7 staining is useful for a rapid diagnosis of CMV infections, Human cytomegalovirus (CMV) is an important pathogen not only for fetuses, but also for immunocompromised hosts such as patients with organ transplantation, acquired immunodeficiency syndrome (AIDS), or neoplastic diseases. Those patients are at high risk for active CMV infection, with CMV pneumonitis being critical event (18). In addition, through its own immunosuppressive effect, active CMV infection itself predisposes the patients to secondary infections by bacteria, fungi or protozoa (3). Therefore, the rapid confirmation of active CMV infections in those patients is essential for early initiation of anti-CMV treatments (21). The most reliable diagnosis of active CMV infections is virus isolation. However, CMV grows so slowly in cell culture that detection of CMV by its typical cytopathic effect (CPE) requires a long incubation for weeks.CMV produces a number of early antigens (EA) in the infected cells before viral 1015

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confidence: 59%

“…However, false-negative result may occur due to the lack of an epitope to be recognized by HRP-C7. To avoid this type of false-negative result, use of the mixture of monoclonal antibodies should be recommended as reported by Griffiths et al (9) and Volpi et al (33).…”

mentioning

confidence: 99%

Rapid Diagnosis of Cytomegalovirus Infections by Direct Immunoperoxidase Staining with Human Monoclonal Antibody against an Immediate‐Early Antigen

Eizuru

Minematsu

Minamishima

et al. 1991

Microbiology and Immunology

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“…Firstly, we have changed our method for detection of CMV infection from the DEAFF 14 to detection of CMV antigenaemia; 19,20 this should greatly improve the detection of CMV infection since the antigenaemia test is more sensitive 19,20 and will detect breakthrough infection during GCV prophylaxis 21 whereas the DEAFF is especially insensitive in this context. Secondly, the period of monitoring for CMV infection has been extended up to day +180 post transplant so that late CMV disease may be predicted and GCV therapy initiated.…”

Section: Discussionmentioning

confidence: 99%

“…The DEAFF (detection of early antigen fluorescent foci) 14 and virus isolation were utilised for the detection of CMV. CMV infection was defined as one or more positive results in blood, urine, throat washings or bronchoalveolar lavage.…”

Section: Detection Of CMV and Definitions Of Cmv Disease And Death Dumentioning

confidence: 99%

A comparison of prophylactic vs pre-emptive ganciclovir to prevent cytomegalovirus disease after T-depleted volunteer unrelated donor bone marrow transplantation

Stocchi

Szydlo

Craddock

et al. 1999

Bone Marrow Transplant

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Summary:The prophylactic and pre-emptive use of ganciclovir (GCV) both reduce significantly the incidence of CMV disease after sibling BMT but it is unclear which of these strategies is best for volunteer unrelated donor (VUD) BMT patients. We reviewed 49 consecutive patients, who received a T-depleted VUD BMT (from March 1990 to March 1996) for the treatment of CML in chronic phase, and were CMV seropositive before transplant or had a CMV seropositive donor. Patients were conditioned with cyclophosphamide (120 mg/kg for 2 days) and total body irradiation (13.2-14.4 Gy). Prophylaxis for GVHD was cyclosporin A and methotrexate with ex vivo or in vivo T cell depletion. Twentyseven patients received pre-emptive GCV if CMV infection was detected by short-term culture before day +120 post BMT. Twenty-two patients received prophylactic GCV from engraftment until day +120 post BMT. The probabilities of CMV infection and disease occurring by 1 year post-BMT were greater in the pre-emptive GCV group than in the prophylactic GCV group (73.8% and 64.0% vs 53.1% and 30.0%, respectively; P = 0.04 and 0.07). The incidence of death from CMV disease was similar in both groups (3/12 (25%) vs 3/10 (30%), respectively) and there was no difference in 1 year survival (55.6% vs 54.2%, respectively). New strategies are urgently required for the prevention of CMV disease after T-depleted VUD BMT.

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“…18 Varicella zoster virus (VZV) infection was defined as the appearance of typical vesicular skin lesions with a dermatomal distribution, and post-herpetic neuralgia as dermatomal pain persisting longer than 28 days after infection onset. 19 Response to antibiotics was classified as 'improvement' if temperature returned to normal and all signs and symptoms disappeared without changes or the addition of other antibiotics, and as 'failure' if temporary, minimal or no response occurred, or if antibiotics changes or additions were required.…”

Section: Definition Criteriamentioning

confidence: 99%

Infectious complications after autologous peripheral blood progenitor cell transplantation followed by G-CSF

Offidani

Corvatta

Olivieri

et al. 1999

Bone Marrow Transplant

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Summary:Infectious complications after autologous peripheral blood progenitor cell transplantation (PBPCT) have been reported in a few studies including small patient numbers. The present study was performed to assess the incidence, types, outcome and factors affecting early and late infections in 150 patients aged 18 to 68 years (median 46.5) who underwent high-dose therapy, with G-CSF. Patients were kept in reverse isolation rooms and received antimicrobial chemoprophylaxis with oral quinolone and fluconazole. One hundred and fifteen patients (76.7%) developed fever (median 3 days, range 1-29); 20 patients (55.5%) had Gram-positive and 13 (36.2%) Gram-negative bacterial infections. There were no fungal infections or infection-related deaths. Mucositis grade II-IV (P ‫؍‬ 0.0001; odds ratio 3.4) and Ͼ5 days on ANC Ͻ100/ l (P ‫؍‬ 0.0001; odds ratio 2.3) correlated with development of infection. Only days with ANC Ͻ100/ l affected infection outcome (P ‫؍‬ 0.0024) whereas the antibiotic regimen did not. After day ؉30 there were four cases of bacterial pneumonitis (2.7%), one case of fatal CMV pneumonia (0.8%) and 20 of localized VZV infection (13.3%). Reduction of neutropenia duration with PBPCT and G-CSF is not enough to prevent early infectious complications since only a few days of severe neutropenia and mucositis are related to development of early infections. However, no infection-related deaths were seen. Although Grampositive organisms were the major cause of bacteremia, a glycopeptide in the empirical antibiotic regimen did not affect infection outcome. In PBPCT recipients, early and late opportunistic infections were notably absent, which was at variance with what was seen with bone marrow recipients. Efforts should be made to prevent mucositis and neutropenia and identify new strategies of antibacterial prophylaxis.

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Rapid Diagnosis of Cytomegalovirus Infection in Immunocompromised Patients by Detection of Early Antigen Fluorescent Foci

Cited by 215 publications

References 21 publications

Rapid Diagnosis of Cytomegalovirus Infections by Direct Immunoperoxidase Staining with Human Monoclonal Antibody against an Immediate‐Early Antigen

Rapid Diagnosis of Cytomegalovirus Infections by Direct Immunoperoxidase Staining with Human Monoclonal Antibody against an Immediate‐Early Antigen

A comparison of prophylactic vs pre-emptive ganciclovir to prevent cytomegalovirus disease after T-depleted volunteer unrelated donor bone marrow transplantation

Infectious complications after autologous peripheral blood progenitor cell transplantation followed by G-CSF

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