title: [Usefulness of urine and blood cultures for diagnosing cytomegalovirus infection in the kidney transplant recipient].
abstract: OBJECTIVE
  To prospectively and comparatively study the usefulness of urine (viruria) and blood (antigenemia pp65 and culture) (viremia) for the diagnosis of cytomegalovirus (CMV) infection in renal transplant (RT) recipients.
  
  
  METHODS
  All RT recipients at our hospital were studied from January 1995 to December 1996. After decontamination, urine specimens were inoculated into two MRC-5 cell line vials. Polymorphonuclear cells were extracted from peripheral blood by sedimentation in saline dextran and were used for antigenemia pp65 test and for culture in shell-vial.
  
  
  RESULTS
  A total of 1,335 specimens from 43 patients were studied. CMV was recovered from 110 out of the 913 (12%) urine specimens and from 101 out of the 422 (23.9%) blood specimens (antigenemia and/or viremia). CMV detection was first obtained by a positive blood test in 23 patients (88.4%), whereas the urine specimen was the first positive test in only three (11.6%) patients (p = 0.0001). A positive result in blood preceded a positive result in urine by a mean of 10.3 days (range: 2-73 days). Antigenemia and viremia were simultaneously positive in 61.5% of patients. In three patients a positive antigenemia preceded viremia by 14 days. In seven patients (26.9%) only the shell-vial culture was positive. Culture preceded antigenemia by a mean of 7.6 days. In the 26 patients, the time elapsed until the first positive blood specimen for CMV was 37.3 days (range: 11-88 days).
  
  
  CONCLUSIONS
  According to the results obtained we believe that blood (antigenemia pp65 and/or viremia) should be considered as the only really useful specimen for the diagnosis of infection/disease caused by CMV in RT recipients. The urine specimen lacks a diagnostic and clinical usefulness and therefore should not be used in these patients.
authors.affiliation: Unidad de Virología, Hospital Universitario Son Dureta (UIB), Palma de Mallorca.
authors.forename: J
authors.initials: J
authors.lastname: Reina Prieto
authors.forename: X
authors.initials: X
authors.lastname: Bestard Palmer
authors.forename: J
authors.initials: J
authors.lastname: Saurina Gomila
authors.forename: J
authors.initials: J
authors.lastname: Gascó Company
authors.forename: V
authors.initials: V
authors.lastname: Fernández-Baca Gutiérrez del Alamo
authors.forename: M
authors.initials: M
authors.lastname: Munar Roca
mesh_terms: D000956:Antigens, Viral / Q000097:blood / Q000652:urine; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D006801:Humans; D016030:Kidney Transplantation; D009894:Opportunistic Infections / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D011446:Prospective Studies; D014766:Viremia
chemical_list: D000956:Antigens, Viral
vernacular_title: Utilidad del cultivo de orina y sangre para el diagnóstico de infección por citomegalovirus en el receptor de trasplante renal.