{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T21:55:26Z","timestamp":1768341326287,"version":"3.49.0"},"reference-count":39,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004844","name":"National Cheng Kung University Hospital","doi-asserted-by":"publisher","award":["10708001"],"award-info":[{"award-number":["10708001"]}],"id":[{"id":"10.13039\/501100004844","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Lots of automated molecular methods for detecting cytomegalovirus (CMV) DNA in the blood are available, but seldom for various clinical specimens. This study was designed to establish a highly sensitive automated assay to detect CMV DNA in non-blood specimens. We designed a new QMT assay using QIAGEN artus CMV RG polymerase chain reaction (Q-CMV PCR) kit applied on the BD MAX system and compared with the other assays, including an RGQ assay (LabTurbo auto-extraction combined Q-CMV PCR kit on Rotor-Gene-Q instrument), and in-house PCR assay. A total of 1067 various clinical samples, including 426 plasma, 293 respiratory tract specimens (RTS), 127 stool, 101 cerebral spinal fluid, 90 vitreous humours were analysed. Examining CMV DNA in simultaneous specimens of the same immunocompromised patient with respiratory symptoms, the detection rate of RTS (93.6%, 88\/94) was significant higher than plasma (65.9%, 62\/94). The positive rates for plasma samples with a low CMV viral load (&lt;137 IU\/mL) and diagnostic sensitivity of QMT, RGQ, and in-house assays were 65% and 99.1%, 45% and 100%, 5% and 65.5%, respectively. The QMT assay performs better, with shorter operational and turnaround time than the other assays, enabling the effective and early detection of CMV infection in various clinical specimens, particularly for RTS.<\/jats:p>","DOI":"10.3390\/microorganisms8071063","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T10:22:02Z","timestamp":1594981322000},"page":"1063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Increasing Cytomegalovirus Detection Rate from Respiratory Tract Specimens by a New Laboratory-Developed Automated Molecular Diagnostic Test"],"prefix":"10.3390","volume":"8","author":[{"given":"Huey-Pin","family":"Tsai","sequence":"first","affiliation":[{"name":"Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"},{"name":"Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chun-Sheng","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I-Ting","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7497-149X","authenticated-orcid":false,"given":"Wen-Chien","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"},{"name":"Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-4046","authenticated-orcid":false,"given":"Jen-Ren","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"},{"name":"Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"},{"name":"Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan 701, Taiwan"},{"name":"National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Tainan 704, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5711","DOI":"10.1182\/blood-2008-10-143560","article-title":"How We Treat Cytomegalovirus in Hematopoietic Cell Transplant Recipients","volume":"23","author":"Boeckh","year":"2009","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Mayaphi, S.H., Brauer, M., Morobadi, D.M., Mazanderani, A.H., Mafuyeka, R.T., Olorunju, S.A., Tintinger, G.R., and Stoltz, A. (2014). Cytomegalovirus Viral Load Kinetics in Patients with HIV\/AIDS Admitted to a Medical Intensive Care Unit: A Case for Pre-Emptive Therapy. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0093702"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s12253-008-9030-3","article-title":"Monitoring of Cytomegalovirus Reactivation in Bone Marrow Transplant Recipients by Real-Time PCR","volume":"4","author":"Ghaffari","year":"2008","journal-title":"Pathol. Oncol. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1097\/00007890-199560120-00018","article-title":"Prophylactic Ganciclovir Treatment Reduces Fungal as Well as Cytomegalovirus Infections after Heart Transplantation","volume":"12","author":"Wagner","year":"1995","journal-title":"Transplantation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jcv.2015.06.006","article-title":"Cytomegalovirus Load at Treatment Initiation Is Predictive of Time to Resolution of Viremia and Duration of Therapy in Hematopoietic Cell Transplant Recipients","volume":"69","author":"Tan","year":"2015","journal-title":"J. Clin. Virol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1097\/TP.0000000000002191","article-title":"The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-Organ Transplantation","volume":"102","author":"Gruden","year":"2018","journal-title":"Transplantation"},{"key":"ref_7","first-page":"393","article-title":"Pulmonary Cytomegalovirus (CMV) DNA Shedding in Allogeneic Hematopoietic Stem Cell Transplant Recipients: Implications for the Diagnosis of CMV Pneumonia","volume":"78","author":"Vinuesa","year":"2019","journal-title":"JInfect"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1089\/jop.2016.0140","article-title":"Cytomegalovirus Retinitis: A Review","volume":"33","author":"Port","year":"2017","journal-title":"JOcul Pharmacol. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1097\/MIB.0000000000001095","article-title":"The Association between CMV Viremia or Endoscopic Features and Histopathological Characteristics of CMV Colitis in Patients with Underlying Ulcerative Colitis","volume":"23","author":"Yang","year":"2017","journal-title":"Inflamm. Bowel. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Rabe, T., Lazar, K., Cambronero, C., Goelz, R., and Hamprecht, K. (2020). Human Cytomegalovirus (HCMV) Reactivation in the Mammary Gland Induces a Proinflammatory Cytokine Shift in Breast Milk. Microorganisms, 8.","DOI":"10.3390\/microorganisms8020289"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1128\/JCM.02558-06","article-title":"Evaluation of Real-Time PCR Laboratory-Developed Tests Using Analyte-Specific Reagents for Cytomegalovirus Quantification","volume":"45","author":"Caliendo","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jviromet.2012.04.010","article-title":"Quantitation of Human Cytomegalovirus DNA in Plasma Using an Affordable in-House qPCR Assay","volume":"183","author":"Khansarinejad","year":"2012","journal-title":"J. Virol. Methods"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.2174\/1874285801711010083","article-title":"Evaluation of a Probe-Based PCR-ELISA System for Simultaneous Semi Quantitative Detection and Genotyping of Human Cytomegalovirus (HCMV) Infection in Clinical Specimens","volume":"11","author":"Talkhabifard","year":"2017","journal-title":"Open Microbiol. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.jcv.2014.10.009","article-title":"Detection of Cytomegalovirus (CMV) by Real-Time PCR in Fecal Samples for the Non-Invasive Diagnosis of CMV Intestinal Disease","volume":"61","author":"Ganzenmueller","year":"2014","journal-title":"J. Clin. Virol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2899","DOI":"10.1128\/JCM.00785-11","article-title":"Comparative Evaluation of Three Automated Systems for DNA Extraction in Conjunction with Three Commercially Available Real-Time PCR Assays for Quantitation of Plasma Cytomegalovirus DNAemia in Allogeneic Stem Cell Transplant Recipients","volume":"49","author":"Bravo","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2703","DOI":"10.1128\/JCM.00721-11","article-title":"Cytomegalovirus DNA Quantification Using an Automated Platform for Nucleic Acid Extraction and Real-Time PCR Assay Setup","volume":"49","author":"Forman","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tsai, H.P., Tsai, Y.Y., Lin, I.T., Kuo, P.H., Chen, T.Y., Chang, K.C., and Wang, J.R. (2016). Comparison of Two Commercial Automated Nucleic Acid Extraction and Integrated Quantitation Real-Time PCR Platforms for the Detection of Cytomegalovirus in Plasma. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0160493"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1002\/jmv.25226","article-title":"Clinical Evaluation of Roche Cobas\u00ae Ampliprep\/Cobas\u00ae Taqman\u00ae CMV Test Using Nonplasma Samples","volume":"90","author":"Hildenbrand","year":"2018","journal-title":"J. Med. Virol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Waggoner, J.J., and Pinsky, B.A. (2014). Comparison of Automated Nucleic Acid Extraction Methods for the Detection of Cytomegalovirus DNA in Fluids and Tissues. PeerJ, 2.","DOI":"10.7717\/peerj.334"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"320","DOI":"10.3343\/alm.2017.37.4.320","article-title":"Rapid Detection of Staphylococcus Aureus and Methicillin-Resistant S. Aureus in Atopic Dermatitis by Using the BD Max StaphSR Assay","volume":"37","author":"Lee","year":"2017","journal-title":"Ann. Lab Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3258","DOI":"10.1128\/JCM.00911-17","article-title":"Multisite Evaluation of the BD Max Extended Enteric Bacterial Panel for Detection of Yersinia Enterocolitica, Enterotoxigenic Escherichia Coli, Vibrio, and Plesiomonas Shigelloides from Stool Specimens","volume":"55","author":"Simner","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1128\/JCM.01766-16","article-title":"Combined Testing for Chlamydia, Gonorrhea, and Trichomonas by Use of the BD Max CT\/GC\/TV Assay with Genitourinary Specimen Types","volume":"55","author":"Williams","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jcv.2018.06.005","article-title":"Detection of Norovirus by BD MaxTM, Xpert \u00ae Norovirus, and xTAG\u00ae Gastrointestinal Pathogen Panel in Stool and Vomit Samples","volume":"105","author":"McHugh","year":"2018","journal-title":"J. Clin. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.diagmicrobio.2018.06.003","article-title":"Evaluation of Alternate Parasite Transport Systems for the BD Max Enteric Parasite Panel","volume":"92","author":"DeBurger","year":"2018","journal-title":"Diagn. Microbiol. Infect Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.cmi.2017.04.022","article-title":"Rapid Detection of Group B Streptococcus Directly from Vaginal-Rectal Specimens Using Liquid Swabs and the BD Max GBS Assay","volume":"23","author":"Ellem","year":"2017","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2865","DOI":"10.1128\/JCM.00641-17","article-title":"Evaluation of the BD Max StaphSR Assay for Detecting Methicillin-Resistant Staphylococcus Aureus (MRSA) and Methicillin-Susceptible S. Aureus (MSSA) in ESwab-Collected Wound Samples","volume":"55","author":"Silbert","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4375","DOI":"10.1128\/JCM.02237-14","article-title":"Development and Optimization of a Real-Time PCR Assay for Detection of Herpes Simplex and Varicella-Zoster Viruses in Skin and Mucosal Lesions by Use of the BD Max Open System","volume":"52","author":"Cardenas","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Koller, T., Kurze, D., Lange, M., Scherdin, M., Podbielski, A., and Warnke, P. (2016). Implementation and Evaluation of a Fully Automated Multiplex Real-Time PCR Assay on the BD Max Platform to Detect and Differentiate Herpesviridae from Cerebrospinal Fluids. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0153991"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1921","DOI":"10.1128\/JCM.03692-14","article-title":"Development and Validation of a Laboratory-Developed Multiplex Real-Time PCR Assay on the BD Max System for Detection of Herpes Simplex Virus and Varicella-Zoster Virus DNA in Various Clinical Specimens","volume":"53","author":"Pillet","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2512","DOI":"10.1093\/jac\/dkx189","article-title":"Clinical Sensitivity and Specificity of the Check-Points Check-Direct ESBL Screen for BD Max, a Real-Time PCR for Direct ESBL Detection from Rectal Swabs","volume":"72","author":"Souverein","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Rocchetti, T.T., Silbert, S., Gostnell, A., Kubasek, C., Jerris, R., Vong, J., and Widen, R. (2018). Rapid Detection of Four Non-Fermenting Gram-Negative Bacteria Directly from Cystic Fibrosis Patient\u2019s Respiratory Samples on the BD Max System. Pract. Lab Med., 12.","DOI":"10.1016\/j.plabm.2018.e00102"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1128\/JCM.00768-16","article-title":"Development of a Real-Time PCR Protocol Requiring Minimal Handling for Detection of Vancomycin-Resistant Enterococci with the Fully Automated BD Max System","volume":"54","author":"Dalpke","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1093\/infdis\/158.6.1185","article-title":"Detection of Cytomegalovirus DNA in Peripheral Blood of Patients Infected with Human Immunodeficiency Virus","volume":"158","author":"Shibata","year":"1988","journal-title":"J. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3860","DOI":"10.1128\/JCM.38.10.3860-3863.2000","article-title":"Comparison of Six Commercial DNA Extraction Kits for Recovery of Cytomegalovirus DNA from Spiked Human Specimens","volume":"38","author":"Fahle","year":"2000","journal-title":"J. Clin. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3749","DOI":"10.1128\/JCM.02005-13","article-title":"Comparison of Six Real-Time PCR Assays for Qualitative Detection of Cytomegalovirus in Clinical Specimens","volume":"51","author":"Binnicker","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1111\/j.1365-2672.2012.05384.x","article-title":"PCR Inhibitors-Occurrence, Properties and Removal","volume":"113","author":"Schrader","year":"2012","journal-title":"J. Appl. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1128\/JCM.39.2.485-493.2001","article-title":"Purification and Characterization of PCR-Inhibitory Components in Blood Cells","volume":"39","author":"Radstrom","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1309\/AJCPE5VZL1ONZHFJ","article-title":"Comparison of QIAGEN Automated Nucleic Acid Extraction Methods for CMV Quantitative PCR Testing","volume":"133","author":"Miller","year":"2010","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.jviromet.2013.07.042","article-title":"Comparison of Two Nucleic Acid Extraction and Testing Systems for HCMV-DNA Detection and Quantitation on Whole Blood Specimens from Transplant Patients","volume":"193","author":"Costa","year":"2013","journal-title":"J. Virol. Methods"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/8\/7\/1063\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:49:12Z","timestamp":1760176152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/8\/7\/1063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,16]]},"references-count":39,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["microorganisms8071063"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms8071063","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,16]]}}}