TABLE 12.
Comparison of cell culture and real-time PCR for the laboratory detection of herpes simplex virus infections from dermal and genital specimens
| Reference | Culture
|
Real-time PCR
|
Comments | ||||
|---|---|---|---|---|---|---|---|
| No. of specimens | No. positive (%) | Cells | No. of specimens | No. positive (%) | Test platform/gene target | ||
| Ryncarz et al. 1999 (422) | 335 (genital tract) | 162 (48.4) | Human diploid fibroblast (24-well microtiter plates) rapid culture technique | 335 | 248 (74.0) | ABI Prism/glycoprotein B | First study of laboratory diagnosis of genital tract specimens by real-time PCR |
| Espy et al. 2000 (118) | 200 (genital, 160; dermal, 38; ocular, 2) | 69 (34.5) | MRC-5 (shell vials) | 200 | 88 (44) | LightCycler/DNA polymerase, thymidine kinase | Feasibility study performed by developmental technologists |
| Espy et al. 2000 (115) | 500 (genital, 288; dermal, 192; ocular, 20) | 158 (31.6) | MRC-5 (shell vials) | 500 | 225 (45) | LightCycler/DNA polymerase, thymidine kinase | Implementation study performed by technologists performing laboratory testing for diagnostic purposes |
| Koenig et al. 2001 (229) | 104 (genital and dermal) | 43 (41.3) | Rabbit kidney (tubes) | 104 | 55 (52.9) | LightCycler/glycoprotein D | SYBR Green I dye detection system |
| Aldea et al. 2002 (4) | 118 (genital tract) | 28 (23.7) | A-549; MRC-5 (tubes) | 118 | 34 (28.8) | LightCycler/DNA polymerase, thymidine kinase | SYBR Green I dye detection system |
| Burrows et al. 2002 (57) | 262 | 36 (13.7) | 262 | 75 (28.6%) | LightCycler/DNA polymerase | LightCycler PCR detected and subtyped HSV in 99% (66/67) of HSV-positive specimens, compared to 81% (54/67) by rapid antigen or 57% (36/63) by culture | |
| van Doornum et al. 2003 (506) | 668 anogenital (dermal, ocular, oral, bronchoalveolar lavage) | 199 (29.8) | Human embryonic lung fibroblasts (24-well microtiter plates), rapid culture technique | 688 | 240 (34.9) | ABI Prism/glycoprotein D, glycoprotein G | 17 (culture) and 27 (PCR) specimens were positive for VZV |
| Wald et al. 2003 (526) | 36,471 specimens (mucosal swabs obtained from a variety of anatomic sites) from 296 subjects | 1,087 (2.9) | Human diploid fibroblasts (microtiter plates), rapid culture technique | 36,461 | 4,415 (12.1) | ABI Prism/glycoprotein B | Of 4,464 samples positive by more than one test (cell culture and PCR) 3,377 (75.7%) were positive by PCR only; 49 (1.1%) were positive by culture only. This study is the most extensive comparison between virus isolation and detection of a pathogen by PCR. Transport of specimens during summertime likely reduced the detection rate of HSV in cell cultures compared to molecular amplification. This conclusion is consistent with the results of a publication demonstrating the stability of nucleic acids after storage (201) |