Biomedical papers - Ahead of Print

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. X:X | 10.5507/bp.2018.023

Detection of cytomegalovirus DNA in fecal samples as a method for CMV enterocolitis diagnosis after allogeneic stem cell transplantation

Alzbeta Zavrelovaa, Jakub Radochaa, Lenka Pliskovab, Pavla Paterovac, Eva Vejrazkovaa, Jiri Cyranyd, Filip Gabaleca, Miroslav Podholae, Pavel Zaka
a 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
b Institute of Clinical Biochemistry, University Hospital Hradec Kralove Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
c Department of Clinical Microbiology, University Hospital Hradec Kralove Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
d 2nd Department of Internal Medicine - Gastroenterology, University Hospital Hradec Kralove Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic
e The Fingerland´s Department of Patology, University Hospital Hradec Kralove Kralove and Faculty of Medicine in Hradec Kralove, Charles University in Prague, Hradec Kralove, Czech Republic

Background: Cytomegalovirus enterocolitis is a rare but potentially life threatening complication after allogeneic stem cell transplantation. Its early diagnosis and treatment are essential for a successful outcome.

Objective: To determine the potential benefit of fecal CMV DNA detection in the diagnosis of CMV colitis among stem cell transplant recipients. Study design. Biopsies from the lower gastrointestinal tract, taken during 69 episodes of diarrhea, were compared with fecal samples previously examined for CMV DNA in 45 patients after allogeneic stem cell transplantation.

Results: Six confirmed cases of CMV colitis were observed, with 16 out of 69 (23%) fecal samples proving positive for CMV DNA. Only one positive sample correlated with histologically confirmed CMV colitis, and 15 samples were evaluated as false positive. These results provide a 16.7% sensitivity and 76.2% specificity in the diagnosis of CMV enterocolitis.

Conclusion: The examination of fecal samples for the presence of CMV DNA has very low potential in the diagnosis of CMV enterocolitis after allogeneic stem cell transplantation; therefore, a biopsy of the gastrointestinal mucosa is still warranted for correct diagnosis.

Keywords: CMV infection, CMV enterocolitis, allogeneic stem cell transplantation

Received: December 11, 2017; Accepted: April 17, 2018; Prepublished online: May 16, 2018


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