title: Evaluation of a multiplex PCR assay for detection of cytomegalovirus in stool samples from patients with ulcerative colitis.
abstract: OBJECTIVE
  To evaluate a multiplex PCR assay for the detection of bacterial and viral enteropathogens in stool samples from patients with ulcerative colitis (UC).
  
  
  METHODS
  We prospectively analyzed 300 individuals, including immunocompetent patients, immunocompromised patients, and patients with UC. Stool samples were collected from the recto-sigmoid region of the colon by endoscopy. The samples were qualitatively analyzed for bacterial and viral enteropathogens with a multiplex PCR assay using a Seeplex(®) Kit. Additional clinical and laboratory data were collected from the medical records.
  
  
  RESULTS
  A multiplex PCR assay detected 397 pathogens (191 bacteria and 206 viruses) in 215 samples (71.7%). The most frequently detected bacteria were Escherichia coli H7, 85 (28.3%); followed by Aeromonas spp., 43 (14.3%); and Clostridium perfringens, 36 (12.0%) samples. The most prevalent viruses were Epstein-Barr virus (EBV), 90 (30.0%); followed by human herpes virus-6 (HHV-6), 53 (17.7%); and cytomegalovirus (CMV), 37 (12.3%) samples. The prevalence rate of CMV infection was significantly higher in the immunocompromised group than in the immunocompetent group (P < 0.01). CMV infection was more common in patients with UC (26/71; 36.6%) than in the immunocompetent patients excluding UC (6/188; 3.2%) (P < 0.01). CMV infection was more prevalent in UC active patients (25/58; 43.1%) than in UC inactive patients (1/13; 7.7%) (P < 0.05). Among 4 groups which defined by the UC activity and immunosuppressive drugs, the prevalence rate of CMV infection was highest in the UC active patients with immunosuppressive drugs (19/34; 55.8%). Epstein-Barr virus (EBV) infection was more common in the immunocompromised patients excluding UC (18/41; 43.9%) than in the immunocompetent patients excluding UC (47/188; 25.0%) (P < 0.05). The simultaneous presence of CMV and EBV and/or HHV6 in UC active patients (14/58; 24.1%) was greater than in immunocompromised patients excluding UC (5/41; 12.2%) (P < 0.05).
  
  
  CONCLUSIONS
  The multiplex PCR assay that was used to analyze the stool samples in this study may serve as a non-invasive approach that can be used to exclude the possibility of CMV infection in patients with active UC who are treated with immunosuppressive therapy.
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Saifun
authors.initials: S
authors.lastname: Nahar
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iraha
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hokama
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Uehara
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Gretchen
authors.initials: G
authors.lastname: Parrott
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ohira
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kaida
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kinjo
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinjo
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hirata
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Nagisa
authors.initials: N
authors.lastname: Kinjo
authors.affiliation: Saifun Nahar, Ayako Uehara, Gretchen Parrott, Tetsu Kinjo, Takeshi Kinjo, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D003113:Colonoscopy; D003587:Cytomegalovirus / Q000235:genetics* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D004279:DNA, Viral / Q000235:genetics* / Q000302:isolation & purification; D005240:Feasibility Studies; D005243:Feces / Q000821:virology*; D005260:Female; D006801:Humans; D007121:Immunocompetence; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009894:Opportunistic Infections / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014773:Virology / Q000379:methods*; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents
keywords: Cytomegalovirus; Epstein-Barr virus; Polymerase chain reaction; Ulcerative colitis; immunosuppressive drugs