Clinical significance of blood and urine testing for cytomegalovirus in pediatric patients hospitalized with community acquired pneumonia and cytomegalovirus infection

Abstract

Abstract Background This study aimed to investigate the clinical significance of detecting cytomegalovirus (CMV) in the blood and urine of pediatric patients hospitalized with community-acquired pneumonia (CAP) and CMV infection. Methods This retrospective case-control study enrolled consecutive pediatric patients admitted with CAP with a positive test result for CMV DNA in bronchoalveolar lavage fluid (BALF). The study participants were further divided into two groups based on CMV serological test results: active CMV infection group and CMV replication group. Clinical characteristics were compared between these two groups. The Kruskal–Wallis test or Mann–Whitney U test was used to compare non-normally distributed continuous variables. The Chi-squared test was used to assess differences in categorical variables. The correlations between CMV copy number and ALT were determined using the Spearman correlation analysis. Results Among 124 patients aged 1–11 months included in this study, 80 (64.5%) patients were categorized as having an active CMV infection and 44 (35.5%) as positive for CMV replication. Co-infection with other pathogens was detected more frequently with CMV replication (n = 29, 65.9%) compared with active CMV infection (n = 35, 43.7%; P = 0.018). Patients with active CMV infection were younger and exhibited higher levels of alanine transaminase (ALT) and aspartate aminotransferase compared with patients with CMV replication (all P < 0.05). The median CMV DNA copy numbers in both blood and urine were higher in patients with active CMV infection than in patients with CMV replication (all P < 0.05). Both the blood and urine CMV DNA copy numbers showed a positive association with ALT (r = 0.237, P = 0.017 for blood and r = 0.309, P = 0.033 for urine). Conclusions Measurement of CMV DNA in blood and urine may be an effective method for monitoring liver function impairment in patients presenting with CAP and concurrent CMV infection.