The infection rate of human cytomegalovirus (CMV) in the general population in our country is very high.The latent virus often becomes activated when patients' immune status turned to immunocompromised,which will cause serious clinical consequences.Because the manifestations of cytomegalovirus infection are nonspecific,the diagnosis of cytomegalovirus infection mainly depends on the laboratory tests.This article will review laboratory diagnostic methods and clinical significance of CMV infection in immunosuppression patients.

Objectives To evaluate bioMerieux VIDAS(Vitek Immune Diagnositc Assay System) Chlamydia test (CHL) and to determine its performance(sensitivity and specificity) by comparing with cell culture. Methods C. trachomatis in urogenital samples was detected by both cell culture and VIDAS CHL. The different results were confirmed by direct fluorescent antibody assay (DFA). The sensitivity to C.trachomatis serotype D and E stocks was alsode tected with VIDAS CHL and cell culture. Results C.trachomatis was found in 33 (20.2%) of 163 urogenital samples by cell culture in coutrast to in 44(27.0%) by VIDA CHL. As the expanded gold standard was defined as either cell culture positive or cell culture negative and both CHL and DFA positive, the sensitivity was 80.5% and 95.3% and the specifiaty were 100% and 97.6% in cell culture and VIDAS CHL, respectively. In the sensitivity test, C. trachomatis serotype D was tested positive at the highest dilution of one to 102 400 dilution and serotype E was at one in 51 200 by cell culture. However, both serotype D and E were tested positive at the highest dilution of one to 6 553 600 by VIDAS CHL. Conclusions Comparing with the expanded gold standard, VIDAS CHL is sensitive and specific for C.trachomatis in urogenital specimens, with simple and short running hours (1 h). First catch urine (FCU), which avoids the painful male swab collectionin male patients, could also be used as specimen in VIDAS CHL test.

Objective To establish a rapid culture method for monitoring of influenza circulation and laboratory diagnosis of individual patients with influenza. Methods Nasal aspirate specimens were spun onto 24-well plate containing confluent monolayers of Madin-Darby Canine Kidney (MDCK) cells. Fluorescein labeled monoclonal antibodies to influenza A and B viruses were used to stain and type the isolates. Results A total of 713 nasal aspirates specimens from patients experiencing influenza-like symptoms was collected in Beijing between December of 2000 and March of 2001, 187(26 2%) specimens were found with influenza A virus and 109(15 3%) with influenza B virus. 2 2% with influenza A and 11 2% with influenza B virus were detected in 89 nasal aspirates specimens between Jan-Apr 2002. Conclusion Prevalence of influenza was low during 2000～2002 year non-epidemic period in Beijing. The combination of shell viral assay and direct immunofluorescent staining can provide a rapid laboratory diagnosis of influenza, which makes possible for the patients to receive treatment of anti-influenza virus drugs.

Objective To evaluate the activities of four demestic macrolides against C. trachomatis and C. pneumoniae by antimicrobiai susceptibility testing. Methods Cell culture and immunoflourescence staining of chlamydial inclusions were used to determine MICs of four demestic macrolides against C. trachomatis and C. pneumoniae. Results MIC (0.5 μg/ml) was found for acylspriramycin,erythromycin and azithromycin against C. trachomatis serovar B while it was 4 μg/ml for acetylspiramycin. Agaisnt C. trachomatis serovar D, MIC was 0.25 μg/mi in both acylspriramycin and azithromycin, and MICs were 0.5 μg/ml and 2 μml in erythromycin and acetylspiramycin, separately. Agaisnt C. pneumoniae TWAR, erythromycin was the most active with MIC≤0. 016 μg/ml, acylspriramycin and azithromycin were the second with same M1C of 0.032 μg/ml. However, acetylspiramycin was less active with 0.5 μg/ml of MIC. Conclusion Except acetylspiramycin, acylspriramycin erythromycin and azithromycin had reliable activities against both C. trachomatis (serovar B and D) and C. pneumoniae.

ObjectiveTo analyze the seroepidemiologic of Mycoplasma pneumoniae infection and evaluate antibiotics medication of some positive patients by follow-up. Methods Serodia-MycolⅡ particle agglutination assay was used to detect serum antibodies against Mycoplasma pneumoniae in 3 134 clinically suspected infections. Mycoplasma pneumoniae infection was determined and seroepidemiologic was analyzed by results of the test, including positive antibody rates in whole subjects, in male or female groups, in different seasons or age groups as well as in different sources. Evaluate antibiotics medication of some positive patients by follow-up. The average days of medication were counted, different antibiotics medication and medication effect were analyzed. Results In 3 134 serum samples from clinically suspected Mycoplasma pneumoniae infections, 350 ( 11.2％ ) were tested with positive antibodies. The positive antibody rate in female patients was 12. 3％ ( 198/1 604), which was higher than 9. 9％ ( 152/1 530) in males (X2 =4. 58,P ＜0. 05). The peak season was found in the fourth quarter (October-December) with 13.2％ of positive antibody and the highest positive rate (32. 8％, 45/137 ) was found in school aged (5 -9 years old )children. Samples from pediatrics clinic and ward were tested to have highest positive rates ( 27. 9％ and 26. 5％, respectively ), comparing that from other sources. Infection due to Mycoplasma pneumoniae was identified in 28％ (7/25) of community-acquired pneumonia (CAP) patients, which is higher than other diseases. Based on the follow-up of 91 antibody positive patients, between 5 to 120 days ( mean 24. 2 days )were counted from appearance of clinical symptoms to clinic visiting/testing. 71 of 91 (78. 0％ ) patients was medicated with macrolide antibiotics, 4 (4. 4％ ) with quinolones, 4 (4. 4％ ) with cephalosporin, and the rest 12 ( 13.2％ ) patients were medicated with other antibiotics or only symptomatic treatment. The average period of antibiotics medication was between 3 to 21 days (mean 8. 2 days). Medication effect results by follow-up were cure in 35 ( 38. 5％ ), improvement in 50 (54. 9％ ), and poor responses in 6 (6. 6％ ).ConclusionsMycoplasma pneumoniae positive rate in female patients was higher than in males, and peak rate was found in the fourth quarter and in school aged children. Samples from pediatrics clinic and ward were tested to have highest positive rates. Physicians could choose first line antibiotics according to laboratory test results of Mycoplasma pneumoniae, and gain good effect.

Objective To assess the efficacy of the two antiviral medications in preventing cytomegalovirus infection and cytomegalovirus disease in renal transplant recipients.Method We searched articles from Pubmed,EMbase,Cochrane Library,Wanfang Med Online,and China's biomedical journal citation database on line.Randomized controlled trials evaluating preemptive treatment and universal prophylaxis for cytomegalovirus infection and cytomegalovirus disease in renal transplant recipients were reviewed.Two reviewers screened studies and assessed study quality according to the study population,intervention measure and results.Finally data from included studies were subjected to meta-analysis.Result Six studies involving total 752 renal transplant recipients were included in this review.Compared with preemptive treatment,universal prophylaxis significantly reduced the risk of cytomegalovirus infection at 3 rd and 12 th month,and the risk of cytomegalovirus disease at 12 th month after transplantation (RR =12.13,95 ％ CI.6.59～22.36,P＜0.05; RR =2.21,95％CI:1.62～3.01,P＜0.05; RR=1.79,95％Chl.22～2.63,P＜0.05).There was no statistically significant difference in the incidence of other opportunistic infection and acute rejection.Conclusion Universal prophylaxis was more effective than preemptive treatment in preventing CMV infection and CMV disease in renal transplant recipients.

A modified dye test with microplate was to be established to detect Toxoplasma antibodies with cell-cultured Toxoplasma gondii. Numbers of stained and unstained tachyzoites were estimated in every 100 tachyzoites in each well after dyeing with methylene blue. The dilution with 50% tachyzoites stained was used as final dilution. Better results of the microplate dye test has been received when the concentration of tachyzoites in suspension reaches 109/ml with 1% sodium citrate as accessory factor.

Objective To evaluate the importance of Torch serologic screening in pregnant women and to investigate the relationship between Torch infection and pregnant women with embryo standstills as well as women with habitual abortion.Methods IIF and capture EIA were used for detection of Torch-IgG and IgM antibodies, respectively. Toxoplasma /rubella virus/CMV/HSV serologic screens were carried out in 303/278/280/236 pregnant women, 27/30/31/25 pregnant women with embryo standstills and 192/214/228/168 women with habitual abortions, respectively.Results The positive rates of toxoplasma(rubella virus, CMV, HSV)-IgG/IgM antibodies were found 2.3%/0.33% (93.2%/1.4%, 88.6%/1.1%, 93.2%/1.3%) in pregnant women, 0/0(96.7%/0, 87.1%/0, 88.0%/0,) in pregnant women with embryo standstills and 1.04%/0(98.6%/0, 91.2%/0, 94.6%/0) in women with habitual abortion, respectively. Only one serum sample was found to be true positive with rubella virus-IgM antibody in 31 Torch-IgM antibodies positive serum samples tested by other hospitals. Conclusion The necessity to screen toxoplasma antibodies in pregnant women should be evaluated due to the low incidence. It is important to determine immune status to rubella virus prior pregnancy for prenatal screening.Further studies are needed before the scheme to diagnose CMV infection during pregnancy can be decided. Serum samples tested with Torch-IgM antibodies should be re-tested with kits from other manufactures or by reference labs to avoid false positive. There are no relationships being found between Torch infection and pregnant women with embryo standstills as well as women with habitual abortion.

Objective To find a new indicator monitoring severe acute respiratory syndrome (SARS) by analyzing expression of lymphocytes and its subsets in SARS. Method Flow cytometer and hematology analyzer were used to detect the expression of lymphocytes and its subsets in 38 patients of SARS. Results Decreasing lymphocytes were found in 84 percent of the patients. The absolute value of lymphocyte subsets (T/B cell, NK cell) also decreased in a certain degree. Patients with decreasing T cell were mostly observed (95%). T helper/inducer (T 4)cells showed a higher rate of decreasing (100%) than T suppressor/killer (T 8)cells (87%). Based on the distribution of lymphocytes and its subsets, T cells demonstrated the greatest rate of decreasing (58%). Most patients had a relative normal B cells and NK cells with a rate of decreasing as little as 2.6% and 5.3%, respectively, more patients showed a decreasing T 4 cells (82%) than that of T 8 cells (34%). Forty-four percent of patients demonstrated a low ratio of T 4 to T 8. Conclusion The lymphocytes and its subsets were impaired in SARS, especially for T lymphocytes, T 4 cells were more seriously damaged than T 8 cells. The absolute counts of lymphocyte subsets showed more significant change of immune cells than relative counts of that in SARS.

Objective To retrospectively study the serum IgG and IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2 in various populations, and analyze the clinical values.Methods From 2008 to 2015, 2 661 pregnant women, 324 infertile women, 2 492 women with abnormal pregnancy history, 623 women with recent abnormal pregnancy, 261 infants with intrauterine growth retardation and other diseases, 170 women for preconceptual examination, and 702 women for physical examination in Beijing were included .Commercial EIA kits were used to detect serum IgG and IgM antibodies to toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1&2. Positive reactions of IgM antibodies to any pathogens were re-tested with another kind of commercial EIA kit. PEMS3.1 software was used for statistical analysis.Results The prevalence of serum IgG or IgM antibodies against toxoplasma, rubella virus, cytomegalovirus and herpes simplex virus type 1& 2 were found within 0.7%-1.6%(0-1.2%) , 85.3%-92.0% ( 0.4%-2.7%) , 89.1%-94.9% ( 0.7%-1.7%) , 74.8%-86.0% ( 0 -0.7%) , 8.1% -17.4% ( 0 -4.1%) respectively in the studied population groups.The prevalence of TORCH IgG and IgM antibodies were not found to be higher in both populations with past suspicious exposure ( infertile women and women with abnormal pregnancy history ) and recent suspicious exposure ( women with recent abnormal pregnancy and infants with intrauterine growth retardation and other diseases) than that in pregnant women and women for preconceptual and physical examination. Conclusion No associations between TORCH infections and the suspicious exposure were found in the populations above.