Cytomegalovirus nosocomial infection following organ transplantation: detection and monitoring. doi: /j.issn

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1 Chinese Journal of Tissue Engineering Research May 14, 2015 Vol.19, No.20 ( ) 1 2 T T T CD14 HLA-G pp65 RT-PCR 3 pp65 PCR pp67 HLA-G ( ) :R318 :A : (2015) PubMed transplantation cytomegalovirus pp65 pp65 DNA IgG IgM. [J] (20): doi: /j.issn Cytomegalovirus nosocomial infection following organ transplantation: detection and monitoring Zhang Li-ping, Bai Jian (Department of Hospital Infection Management, Liaoning Hospital of Traditional Chinese Medicine, Shenyang , Liaoning Province, China) Abstract BACKGROUND: Cytomegalovirus is one of the opportunistic infection viruses for organ transplant patients, and it can lead to functional loss of organ grafts and even endanger lives. Therefore, accurate diagnosis of cytomegalovirus infection at early phase is the key to clinical treatment. OBJECTIVE: To analyze the detection method, accuracy, detection time and clinical significance of Zhang Li-ping, Nurse in charge, Department of Hospital Infection Management, Liaoning Hospital of Traditional Chinese Medicine, Shenyang , Liaoning Province, China Corresponding author: Bai Jian, Department of Hospital Infection Management, Liaoning Hospital of Traditional Chinese Medicine, Shenyang , Liaoning Province, China Accepted: P.O. Box 10002, Shenyang

2 . cytomegalovirus infection after organ transplantation. METHODS: A computer-based search of VIP, PubMed and CNKI as well as manual search of books were performed for literatures concerning organ transplantation and cytomegalovirus infection published from January 2007 to December The keywords were transplantation, cytomegalovirus in English and Chinese, respectively. Total papers in English and 31 articles in Chinese were found. Among them, only 35 papers which were highly representative and published in related authoritative journals were chosen for further analysis. RESULTS AND CONCLUSION: The main non-invasive detection of cytomegalovirus infection is still the test of CMV-pp65 antigen with good sensitivity and specificity which can accurately reflect the status of cytomegalovirus infection. This method is also the most important clinical diagnostic method. Molecular biological detection of cytomegalovirus can detect potentially infected people, and this method can detect the infection earlier than CMV-pp65 antigen method, which is suitable for the early diagnosis of cytomegalovirus infection and early drug treatment. Quantitative nucleic acid test can be used to analyze cytomegalovirus-dna copies so as to determine the concentrations of the virus in patients, which may provide a more sensitive monitoring way for inapparently infected patients. Cytomegalovirus-IgG and cytomegalovirus-igm in serum can be used to determine whether organ transplant recipients have been infected by cytomegalovirus. Virus culture and histological examination have been used for several years, both of which are the gold standard for detecting cytomegalovirus. However, these methods cannot be used in early diagnosis and active infection. Immunological detection method provides a new ideal for the diagnosis of cytomegalovirus infection. This method can monitor cytomegalovirus infection from early phase accurately and assess the risk of cytomegalovirus, providing a new way for the development of the diagnosis of cytomegalovirus infection. Subject headings: Tissue Engineering; Organ Transplantation; Cytomegalovirus Funding: the National Natural Science Foundation of China, No Zhang LP, Bai J. Cytomegalovirus nosocomial infection following organ transplantation: detection and monitoring. Zhongguo Zuzhi Gongcheng Yanjiu. 2015;19(20): Introduction (Cytomegalovirus CMV) β Craig [1] nm DNA kb 200 [2] [3] 50% [4] 100% [5] TT [6] 60% 80% [7] 80% [8] 1 Data and methods 1.1 PubMed transplantation cytomegalovirus Comprehensive extraction [1-35] pp65 (6.5 kb) ISSN CN /R CODEN: ZLKHAH 3259

3 . 1 UL IE DNA 2 10 d pp65 pp65 pp65 pp65 > 9 /10 5 pp65 pp65 ABC [9] (catalyzed signal amplification CSA) pp65 pp65 [10] pp65 90% pp65 8 h pp65 PCR PCR PCR [11] PCR pp71 pp65 PCRPCR PCR PCR 96.7% 92% [12] PCR PCR pp65 pp65 PCR 87.5% [13] PCR Hanfler [14] PCR [15] PCR PCR pp65 Stocher [16] PCRDNA IE E L L 3 L-mRNA pp67 UL-65 L-mRNA [17] pp67 [18] 2005 pp67-mrna RNA 2 h pp67-mrna RT-PCR pp67-mrna Blank [19] pp67-mrna 3260 P.O. Box 10002, Shenyang

4 . pp65 pp65 pp67-mrna DNA DNA DNA DNA [20] DNA DNA 20 DNA [21-23] 33 DNA DNA [24] IgG IgM IgG IgG 70% IgG IgG4 IgM pp IgM IgM IgG IgM IgG IgM [25] [26] h pp pp6590% [27] T TT CD8 + T CD4 + T T [28-29] Egli [30] pp65cd4 + T 0.03% [31] T CD38 CD38 + CD8 + T 100%91% 269 CD38 + CD3 + CD8 + T CD38 + CD3 + CD8 + T [32] NKG2C + NK [33] ISSN CN /R CODEN: ZLKHAH 3261

5 . CD57 + NKG2C + NK CD57 + NKG2C + NK NK HLA-G HLA-G 7 HLA-G1-4 HLA-G5-7 HLA-G 215 HLA-G CD14 + HLA-G + [34] CD14 + HLA-G + 3 Conclusion 80% 15% 30% [7 35] pp65 90% pp65 DNA RNA DNA IgG IgM IgG IgM DNA 4 References [1] Craig JM, Macauley JC, Weller TH, et al. Isolation of intranuclear inclusion producing agents from infants with illnesses resembling cytomegalic inclusion disease. Proc Soc Exp Biol Med. 1957:94(1):4-12. [2] Ariza-Heredia EJ, Nesher L, Chemaly RF. Cytomegalovirus diseases after hematopoietic stem cell transplantation: a mini-review. Cancer Lett. 2014;342(1):1-8. [3] Minton K. Viral immunity: How CMV bypasses immune memory. Nat Rev Immunol. 2010;10(5):288. [4] Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys Clin Infect. Dis. 2010;50(11): [5],,,. : [J].,2014,18(27): [6] Boeckh M. Complications, Diagnosis, Management, and Prevention of CMV Infections: Current and Future. Hematology Am Soc Hematol Educ Program. 2011; [7] Green ML, Leisenring W, Stachel D, et al. Efficacy of a viral load-based, risk-adapted, preemptive treatment strategy for prevention of cytomegalovirus disease after hematopoietic cell transplantation. Biol Blood Marrow Transpl. 2012;18(11): [8] Lisboa LF, Asberg A, Kumar D, et al. The clinical utility of whole blood versus plasma cytomegalovirus viral load assays for monitoring therapeutic response. Transplantation. 2011; 91(2): [9] Plosa EJ, Esbenshade JC, Fuller MP, et al. Cytomegalovirus Infection. Pediatr Rev. 2012,33(4): [10],. pp65 CMV [J]., 2008, 28(2): P.O. Box 10002, Shenyang

6 . [11] Martin JM, Danziger-Isakov LA. Danziger-Isakov2 Cytomegalovirus risk, prevention, and management in pediatric solid organ transplantation. Pediatr Transpl. 2011; 15(3): [12] Roman A, Manito N, Campistol JM, et al. The impact of the prevention strategies on the indirect effects of CMV infection in solid organ transplant recipients. Transplant Rev (Orlando). 2014;28: [13],,,. RT-PCR [J]. ( ),2007,7(4): [14] Hanfler J, Kreuzer KA, Laurisch K, et al. Quantitation of cytomegalovirus (hcmv) DNA and beta-actin DNA by duplex realtime fluorescence PCR in solid organ (liver)transplant recipients. Med Microbiol Inununol. 2003;192(4): [15],,,. PCR [J].,2007,11(5): [16] Stoeher M, Berg J. Normailized quantification of human cytomegalovious DNA by competitive real-time PCR on the Light Cyrcler instrument. J Clin Microbilol. 2002;40(12): [17] Mewara A, Mishra B, Ratho RK, et al. Comparison of PCRs for IE-1 and gb genes with ELISA of IgM antibodies for diagnosis of human cytomegalovirus disease. Acta Virol. 2010;54(4): [18] Ahmadinejad Z, Ardalan FA, Razzaqi M, et al. QuantiFERON-TB Gold in Tube test for diagnosis of latent tuberculosis (TB) in solid organ transplant candidates: a single-center study in an area endemic for TB. Transpl Infect Dis. 2013;15(1): [19] Longworth SA, Vinnard C, Lee I, et al. Risk factors for nontuberculous mycobacterial infections in solid organ transplant recipients: a case-control study. Transpl Infect Dis. 2014;16: [20] Giulieri S, Manuel O. QuantiFERON(R)-CMV assay for the assessment of cytomegalovirus cell-mediated immunity. Expert Rev Mol Diagn. 2011;11(1): [21] Wiita AP, Roubinian N, Khan Y, et al. Cytomegalovirus disease and infection in lung transplant recipients in the setting of planned indefinite valganciclovir prophylaxis. Transpl Infect Dis. 2012;14(3): [22] Ren Y, Ding Q, Zhang X. Ficolins and infectious diseases. Virol Sin. 2014;29(1): [23] Wadhawan M, Gupta S, Goyal N, et al. Cytomegalovirus infection: its incidence and management in cytomegalovirus-seropositive living related liver transplant recipients: a single-center experience. Liver Transpl. 2012; 18(12): [24] Kotton CN. CMV: prevention, diagnosis and therapy. Am J Transpl. 2013;13(s3): [25] Hoyo I, Sanclemente G, Cervera C, et al. Opportunistic pulmonary infections in solid organ transplant recipients. Transplant Proc. 2012;44(9): [26] Blyth E, Clancy L, Simms R, et al. Donor-derived CMVspecific T cells reduce the requirement for CMV-directed pharmacotherapy after allogeneic stem cell transplantation. Blood. 2013;121(18): [27] Witzke O, Hauser IA, Bartels M, et al. Valganciclovir prophylaxis versus preemptive therapy in cytomegaloviruspositive renal allograft recipients: 1-year results of a randomized clinical trial. Transplantation. 2012;93(1): [28] Avkan-Oguz V, Ozkardesler S, Unek T, et al. Risk factors for early bacterial infections in liver transplantation. Transpl Proc. 2013;45(7): [29] Emery VC, Asher K, Sanjuan CJ. Importance of the cytomegalovirus seropositive recipient as a contributor to disease burden after solid organ transplantation. J Clin Virol. 2012;54(2): [30] Abate D, Saldan A, Mengoli C, et al. Comparison of CMV ELISPOT and CMV QuantiferonTM interferon-c releasing assays in assessing risk of CMV infection in kidney transplant Recipients. J Clin Microbiol. 2013;51(8): [31],,,. T CD38[J]., 2006, 26(3): [32] Ticha O, Stouracova M, Kuman M, et al. Monitoring of CD38high expression in peripheral blood CD8+ lymphocytes in patients after kidney transplantation as a marker of cytomegalovirus infection. Transpl Immunol. 2010;24(1): [33] Bestard O, Lucia M, Crespo E, et al. Pretransplant immediately early-1-specific T cell responses provide protection for CMV infection after kidney transplantation. Am J Transplant. 2013;13: [34],,,.HLA-G [J].,2011,32(9): [35] Clari MA, Munoz-Cobo B, Solano C, et al. Performance of the QuantiFERON-cytomegalovirus (CMV) assay for detection and estimation of the magnitude and functionality of the CMV-specific gamma interferon-producing CD8(+) T-cell response in allogeneic stem cell transplant recipients. Clin Vaccine Immunol. 2012;19(5): ISSN CN /R CODEN: ZLKHAH 3263