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We compared direct VIC in 1109 consecutive bronchoalveolar lavage fluids (BALFs) and a well\u2010validated CMV\u2010QNAT (Basel\u2010CMV\u2010UL111a\u201077bp). In the retrospective Group\u00a01 (<jats:italic>N<\/jats:italic>\u2009=\u2009694) and Group\u00a02 (<jats:italic>N<\/jats:italic>\u2009=\u2009303), CMV\u2010QNAT was performed within 48\u2009h from 2\u2010fold and 10\u2010fold concentrated total nucleic acid (TNA) eluates, respectively. In Group\u00a03 (<jats:italic>N<\/jats:italic>\u2009=\u2009112), 2\u2010fold and 10\u2010fold concentrated TNA eluates were prospectively analyzed in parallel to VIC. CMV was detected by VIC in 79 of 694 (11%) and 26 of 303 (9%) of Groups 1 and 2, but in 114 of 694 (16%) and 57 of 303 (17%) by CMV\u2010QNAT, respectively. Median CMV loads were significantly higher in VIC\u2010positive than in VIC\u2010negative BALF. The likelihood for CMV detection by VIC was 85% for BALF CMV\u2010 loads\u00a0&gt;4\u2009log<jats:sub>10<\/jats:sub> copies\/ml. In the prospective Group\u00a03, CMV was detected by VIC in 10\u00a0of 112 (9%), and in 14 of 112 (13%) and 20 of 112 (18%) by CMV\u2010QNAT, when using 2\u2010fold and 10\u2010fold concentrated TNA eluates, respectively. Notably, CMV was undetectable by CMV\u2010QNAT in 10 VIC\u2010positive cases of Groups 1 and\u00a02, but in none of Group 3. We conclude that CMV\u2010QNAT can be adopted to BALF diagnostics but requires several careful steps in validation. CMV\u2010QNAT loads\u00a0&gt;10\u2009000 copies\/ml\u00a0in BALF may indicate significant CMV replication as defined by VIC, if short shipment and processing procedures can be guaranteed. Discordance of detecting CMV in time\u2010matched plasma samples emphasises the role of local pulmonary CMV replication, for which histopathology remains the gold standard of proven CMV pneumonia.<\/jats:p>","DOI":"10.1002\/jmv.26649","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T10:22:23Z","timestamp":1604312543000},"page":"3804-3812","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Comparing cytomegalovirus diagnostics by cell culture and quantitative nucleic acid testing in broncho\u2010alveolar lavage fluids"],"prefix":"10.1002","volume":"93","author":[{"given":"Karoline","family":"Leuzinger","sequence":"first","affiliation":[{"name":"Clinical Virology, Laboratory Medicine University Hospital Basel Basel Switzerland"},{"name":"Transplantation &amp; Clinical Virology, Department of Biomedicine University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiana","family":"Stolz","sequence":"additional","affiliation":[{"name":"Medical Faculty University of Basel Basel Switzerland"},{"name":"Clinic of Pneumology and Pulmonary Cell Research University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Gosert","sequence":"additional","affiliation":[{"name":"Clinical Virology, Laboratory Medicine University Hospital Basel Basel Switzerland"},{"name":"Transplantation &amp; Clinical Virology, Department of Biomedicine University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaudia","family":"Naegele","sequence":"additional","affiliation":[{"name":"Clinical Virology, Laboratory Medicine University Hospital Basel Basel Switzerland"},{"name":"Transplantation &amp; Clinical Virology, Department of Biomedicine University of Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spasenija S.","family":"Prince","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tamm","sequence":"additional","affiliation":[{"name":"Medical Faculty University of Basel Basel Switzerland"},{"name":"Clinic of Pneumology and Pulmonary Cell Research University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-0423","authenticated-orcid":false,"given":"Hans H.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Clinical Virology, Laboratory Medicine University Hospital Basel Basel Switzerland"},{"name":"Transplantation &amp; Clinical Virology, Department of Biomedicine University of Basel Basel Switzerland"},{"name":"Medical Faculty University of Basel Basel Switzerland"},{"name":"Infectious Diseases &amp; Hospital Epidemiology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12002"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.664"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0051340"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","unstructured":"LjungmanP de laCamaraR RobinC et al. 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