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2020, vol. 73, br. 1-2, str. 43-48
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Poređenje seroloških i molekularnih metoda u dijagnostici infekcija citomegalovirusom kod pacijenata na dijalizi
Comparison of serological and molecular methods in the diagnosis of cytomegalovirus infections in dialysis patients
aUniverzitet u Novom Sadu, Medicinski fakultet, Srbija + Klinički centar Vojvodine, Centar za laboratorijsku medicinu, Novi Sad, Srbija bHigh Medical and Business-Technology School of Professional Studies, Šabac cUniverzitet u Novom Sadu, Medicinski fakultet, Srbija + Univerzitet u Novom Sadu, Medicinski fakultet, Institut za zdravstvenu zaštitu dece i omladine, Srbija dUniverzitet u Novom Sadu, Medicinski fakultet, Katedra za farmaciju, Srbija eUniverzitet u Novom Sadu, Medicinski fakultet, Katedra opšteobrazovnih predmeta, Srbija
e-adresa: jelena.stojcevic-maletic@mf.uns.ac.rs
Sažetak
Uvod. Citomegalovirus je najčešći uzrok infekcija u posttransplantacionom periodu. Pouzdana i pravovremena laboratorijska dijagnoza infekcije citomegalovirusom kod pacijenata na dijalizi i u posttransplantacionom periodu je značajna zbog mogućnosti prevencije ili ublažavanja posledica citomegalovirusne bolesti. Glavni cilj ovog istraživanja je poređenje serološke sa molekularnom metodom lančane reakcije polimeraze za određivanje prisustva citomegalovirusa u krvi pacijenata na dijalizi. Materijal i metode. Ispitivanjem je bilo obuhvaćeno 28 pacijenata na dijalizi, potencijalnih recipijenata za transplantaciju bubrega. Svim pacijentima je određivano prisustvo citomegalovirusa u krvi kvantitativnom metodom lančane reakcije polimeraze, a paralelno u serumu i prisustvo antitela na citomegalovirus, imunoglobulina G i imunoglobulina M. Rezultati. Uporednom enzim-imunoesej metodom detekcije antitela kod pacijenata na dijalizi 96,4% je nekada bilo izloženo virusu, dok je 7,1% pokazalo trenutnu infekciju koja nije potvrđena testom lančane reakcije polimeraze. Upotrebom ch2 i Fišerovog testa nije dokazana statistički značajna povezanost između pozitivnog nalaza antitela imunoglobulina M na citomegalovirus i nalaza citomegalovirusa metodom lančane reakcije polimeraze (p > 0,05). Zaključak. Zbog 7,1% lažno pozitivnih nalaza na prisustvo antitela imunoglobulina M na citomegalovirus u serumu imunokompromitovanih pacijenata na dijalizi koje test lančane reakcije polimeraze nije potvrdio, serološke tehnike nisu pouzdane u detekciji aktivne infekcije citomegalovirusom zbog čega pozitivni nalazi antitela imunoglobulina M na citomegalovirus zahtevaju potvrdu deoksiribonukleinske kiseline citomegaloirusa metodom lančane reakcije polimeraze.
Abstract
Introduction. Cytomegalovirus is the most common cause of infections in the post-transplantation period. A reliable and timely laboratory diagnosis of cytomegalovirus infection in patients on dialysis and in the post-transplantation period is significant because of the possibility of preventing or mitigating the effects of cytomegalovirus disease. The main objective of this study was to compare serological and molecular polymerase chain reaction methods to determine the presence of cytomegalovirus in the blood of dialysis patients. Material and Methods. The study included 28 dialysis patients, potential renal transplant recipients. All patients were evaluated for the presence of cytomegalovirus in the blood by a quantitative polymerase chain reaction method as well as in the serum for the presence of anti-cytomegalovirus Immunoglobulin G and Immunoglobulin M antibodies. Results. According to the comparative enzyme-linked immunosorbent assay for detecting antibodies in dialysis patients, 96.4% were once exposed to the virus, while 7.1% showed current infection not confirmed by polymerase chain reaction test. No statistically significant association was found between the positive finding of anti-cytomegalovirus Immunoglobulin M antibodies and the findings of the polymerase chain reaction cytomegalovirus method when Chi-square (ch2 ) and Fisher's correlation tests were conducted (p > 0.05). Conclusion. Due to 7.1% false positives results for the presence of anti-cytomegalovirus Immunoglobulin M antibodies in the serum of immunocompromised dialysis patients, not confirmed by polymerase chain reaction test, serological techniques are not reliable in detecting active cytomegalovirus infection causing positive finding of anti-cytomegalovirus Immunoglobulin M, so confirmation of cytomegalovirus deoxyribonucleic acid by polymerase chain reaction method is required.
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