İstanbul Tıp Fakültesi Hastanesi'nde CMV enfeksiyonlarına ilişkin serolojik ve moleküler test verilerinin retrospektif değerlendirmesi

Abstract

Amaç: Bu çalışma, 2021–2023 yılları arasında sitomegalovirüs (CMV) enfeksiyonu şüphesiyle İstanbul Tıp Fakültesi Hastanesine başvuran hastaların serolojik (CMV IgM ve IgG) ve moleküler (CMV DNA PCR) test sonuçlarını retrospektif olarak değerlendirmektedir. Çalışmanın amacı, serolojik ve moleküler yöntemlerin birlikte kullanılmasının tanısal değerini ortaya koymak ve yaş ile cinsiyet grupları arasında CMV pozitifliğini analiz etmektir. Gereç ve Yöntem: Bu kesitsel gözlemsel çalışmaya, 1 Ocak 2021–31 Aralık 2023 tarihleri arasında İstanbul Tıp Fakültesi Tıbbi Mikrobiyoloji Laboratuvarında CMV testleri (IgM, IgG ve/veya DNA PCR) yapılan 1.649 hasta dahil edilmiştir. Serolojik testler ELISA (Vircell, İspanya) ile yapılmış, CMV DNA gerçek zamanlı PCR (QIAsymphony/Artus CMV QS-RGQ ve cobas® 6800) ile kantitatif olarak analiz edilmiştir. Veriler anonimleştirilmiş ve SPSS v26.0 programı kullanılarak istatistiksel olarak değerlendirilmiştir. Mann-Whitney U, Ki-Kare, McNemar ve ROC testleri uygulanmış; p<0.05 anlamlı kabul edilmiştir. Bulgular: Toplam 1.649 hastanın (%52,9 erkek, ortanca yaş 32,6 yıl) sonuçları incelendiğinde, CMV IgM pozitifliği düşük bulunmuştur (%2,67). CMV IgG %61,54 oranında pozitif olup orta düzeyde seroprevalansı göstermiştir. CMV DNA PCR %27,78 oranında pozitif olup seronegatif olguları da içermektedir. IgM ve IgG pozitifliği yaş (p=0,999, p=0,287) veya cinsiyet (p>0,05) açısından anlamlı farklılık göstermemiştir. Ancak CMV DNA pozitifliği yaş gruplarına göre anlamlı farklılık göstermiştir (p<0,001) ve en yüksek oran 46–60 yaş grubunda (%31,9) saptanmıştır. Sonuç: Serolojik testler tek başına, özellikle ileri yaşlı veya immünkompromize hastalarda aktif CMV enfeksiyonlarını saptamada yetersiz kalabilmektedir. PCR temelli moleküler testler tanıda tamamlayıcı kritik bir rol oynamakta olup, yüksek riskli popülasyonlarda önceliklendirilmelidir. Serolojik ve moleküler bulguların klinik yansımalarını daha iyi anlamak için çok merkezli prospektif çalışmalara ihtiyaç vardır.

Keywords

• Cytomegalovirus
• CMV DNA
• Seroprevalans

Retrospective evaluation of serological and molecular test data related to CMV infections at İstanbul Faculty of Medicine Hospital

Abstract

Aims: This study retrospectively evaluates the serological (CMV IgM and IgG) and molecular (CMV DNA PCR) test results of patients admitted to İstanbul Faculty of Medicine Hospital between 2021 and 2023 due to suspected cytomegalovirus (CMV) infection. The aim is to assess the diagnostic value of combining serological and molecular methods and to analyze CMV positivity across age and gender groups. Methods: This cross-sectional observational study included 1.649 patients who underwent CMV testing (CMV IgM, CMV IgG, and/or CMV DNA PCR) at the Medical Microbiology Laboratory of İstanbul Faculty of Medicine between January 1, 2021, and December 31, 2023. Serological tests were performed using ELISA (Vircell, Spain), and CMV DNA was quantified using real time PCR (QIAsymphony/Artus CMV QS-RGQ and cobas® 6800). Data were anonymized and analyzed statistically using SPSS v26.0. Mann-Whitney U, Chi-square, McNemar, and ROC tests were applied; p<0.05 was considered significant. Results: Among 1.649 patients (52.9% male, 47.1% female, median age 32.6 years), CMV IgM positivity was low (2.67%), while CMV IgG was positive in 61.55%, indicating moderate seroprevalence. CMV DNA PCR was positive in 27.77%, including seronegative cases. While IgM and IgG positivity did not significantly differ by age (p=0.999, p=0.287) or gender (p>0.05), CMV DNA positivity varied significantly across age groups (p<0.001), highest in individuals aged 61+ (32.1%). Conclusion: Serological tests alone may be insufficient to detect active CMV infections, especially in older or immunocompromised patients. PCR-based molecular testing plays a crucial complementary role in diagnosis and should be prioritized in high-risk populations. Future multicenter prospective studies are needed to better understand the clinical implications of serological and molecular findings.

Keywords

• Cytomegalovirus
• CMV DNA
• seroprevalence

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