PEDIATRICS Vol. 65 No. 2 February 1980, pp. 251-257
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Comparative Study of Diagnostic Procedures for Congenital Cytomegalovirus Infection

Sergio Stagno MD1, R. F. Pass MD1, D. W. Reynolds MD1, M. A. Moore 1, A. J. Nahmias MD1, and C. A. Alford MD1

1 Departments of Pediatrics and Microbiology, The University of Alabama in Birmingham, and the Department of Pediatrics, Emory University School of Medicine, Atlanta

In a prospective study the incidence of congenital cytomegalovirus (CMV) infection was 2.2% (31 of 1,412) as evidenced by viruria during the first week of life. Among immunoserologic methods used to screen these neonates, the rheumatoid factor test, although non-specific, proved to be the most convenient; its sensitivity for identifying infants with CMV infection was 35% to 45% with no false-positives. The rates for correct and incorrect identification of neonates at risk was, respectively, 33% and 3.1% when testing for increased levels of IgM; 5% and 10% when testing for increased levels of IgA; 76% and 21% when testing for IgM anti-CMV (IgM immunofluorescent test) antibody, and 0% when testing for IgA anti-CMV antibody. Rapid virologic diagnosis was achieved by assessing urine specimens. Confirmation by electron microscopy was possible in less than one hour in 92% of cases. The detection of early induced CMV-specific nuclear antigens by anticomplement immunofluorescence was diagnostic in 91% of cases within one day of inoculation of specimens in tissue culture. Infectivity of CMV in urine was well preserved for at least seven days at 4 C. Thus, in order to achieve a rapid diagnosis of congenital CMV infection, in sick as well as asymptomatic neonates, urine specimens may, if necessary, be transported at 4 C to distant laboratories.

Submitted on April 5, 1979
Accepted on May 21, 1979




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