Evaluation of a Non-invasive Method to Detect Cytomegalovirus (CMV)-DNA in Stool Samples of Patients with Inflammatory Bowel Disease (IBD): A Pilot Study
Evaluation of a Non-invasive Method to Detect Cytomegalovirus (CMV)-DNA in Stool Samples of Patients with Inflammatory Bowel Disease (IBD): A Pilot Study
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DOI：
10.1007/s10620-010-1146-0
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发表时间：
2010-04-01
影响因子：
3.1
通讯作者：
Miller, Melissa B.
中科院分区：
文献类型：
--
作者：
Herfarth, Hans H.;Long, Millie D.;Miller, Melissa B.
背景：接受免疫抑制治疗的IBD患者发生严重的结肠炎可能并发潜在的CMV感染。本试点研究的目的是探讨定量聚合酶链反应（PCR）检测CMV DNA在IBD patients.Methods的粪便样本中的诊断效果21例IBD，不完全反应或难治性，无论是类固醇或免疫抑制剂的严重耀斑，被列入本研究。19例患者根据方案完成了研究，接受了内镜检查、活检和粪便样本采集。结果32%（6/19）的患者结肠活检组织中检出CMV DNA，其中5例（83%）患者粪便中检出CMV DNA。13例患者活检和粪便标本中CMV DNA阴性。的敏感性，特异性，和准确性的PCR为基础的粪便测试检测CMV DNA相比，PCR为基础的检测粘膜活检中的CMV分别为83，93，和90%.Conclusions的试点研究表明，这种非侵入性的检测方法，以检测粪便样本中的CMV DNA相比，粘膜活检的准确性高。这种方法可以提供一种非内窥镜检测模式，用于IBD严重发作患者的潜在CMV感染，也可以更广泛地应用于确定IBD患者的CMV感染患病率。
Background A severe flare of colitis in patients with IBD treated with immunosuppressive therapy may be complicated by an underlying CMV infection. The aim of this pilot study was to investigate the diagnostic efficacy of quantitative polymerase chain reaction (PCR) to detect CMV DNA in stool samples of IBD patients.Methods Twenty-one patients with a severe flare of IBD, incompletely responding or refractory to either steroids or immunosuppressive agents, were included in the study. Nineteen patients completed the study according to the protocol undergoing an endoscopy with biopsies and collection of stool samples. Biopsy and stool samples were qualitatively and quantitatively analyzed for CMV DNA using real-time PCR.Results Thirty-two percent (6/19) of the patients had detectable CMV DNA in colonic biopsies and in five (83%) of those patients CMV DNA was detected in the stool. Thirteen patients had negative findings for CMV DNA in biopsy and stool samples. The sensitivity, specificity, and accuracy of the PCR-based stool test for detection of CMV DNA compared to PCR-based detection of CMV in mucosal biopsies were 83, 93, and 90%, respectively.Conclusions The pilot study suggests a high accuracy of this non-invasive testing method to detect CMV DNA in stool samples as compared to mucosal biopsies. This approach may offer a non-endoscopic testing modality for underlying CMV infection in patients with a severe flare of IBD, which could also be applied more broadly to determine the prevalence of CMV infections in patients with IBD.