Abstract:
objective
To explore the significance of combined quantitative detection of urine and milk HCMV-DNA in the diagnosis of cytomegalovirus infection in infants with negative  human cytomegalovirus(HCMV)-IgM.
Methods
A total of 304 children with suspected HCMV infection treated in Yichang Central People's Hospital from Jan. 2013 to Dec. 2015 were chosen. According to the children's chief complaint, physical examination and clinical first diagnosis, these children were divided into 3 groups: hepatitis group(786 children),pneumonia group(71 children) and a third group(47 children whose chief complaint was fever and diarrhea). The results of HCMV-DNA fluorescence quantitative PCR in urine of the children and breast milk of mothers were analyzed.
Results
The detection rate of urine HCMV-DNA in hepatitis group and a third group was 41.94%(78/186) and 51.06%(24/47), which was significantly lower than that in breast milk(53.76%,100/186;72.34%,34/47), the difference being statistically significant(P<0.05). There was no significant difference between the urine HCMV-DNA detection rate and that of the breast milk in the pneumonia group(P>0.05). There was no significant difference in the positive rate of HCMV-DNA in urine and breast milk among the three groups(P>0.05). The urine and milk were both positive in 88 cases(28.95%), milk positive in 174 cases(57.24%), urine positive in 141 cases(46.38%).
Conclusion
Breast milk is an important source of HCMV infection in infants. Under the condition of negative HCMV-IgM antibody, combined detection of HCMV-DNA in urine and milk can increase the positive rate of detection and avoid missed detection.

Key words: Cytomegalovirus infection, Urine, Breast milk, Baby