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Development of a combined CMV-UL97 C592F and CMV-UL54 T503I resistance mutation during ganciclovir treatment in a kidney transplant recipient

Karrasch, Matthiasa,b; Michel, Detlefc; Schneider, Sibylled; Baier, Michaela; Busch, Martind

Reviews in Medical Microbiology: October 2019 - Volume 30 - Issue 4 - p 197–199
doi: 10.1097/MRM.0000000000000190

In CMV high-risk kidney transplant recipients (KTR), recommended antiviral human cytomegalovirus (CMV) treatment can lead to nephrotoxicity and antiviral resistance. In this case report, we report the development of a combined CMV-UL97 C592F and CMV UL54 T503I resistance mutation in a high-risk KTR most probably linked to the previous treatment with valganciclovir (valGCV) and ganciclovir (GCV). Routine CMV screening, in addition with testing of CMV immunity and applied stewardship programs for ganciclovir might have been helpful in preventing the development of these mutations in this patient.

aInstitute of Medical Microbiology

bInstitute of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Jena

cInstitute for Virology, Ulm University Hospital, Ulm

dDepartment of Internal Medicine III, Jena University Hospital, Jena, Germany.

Correspondence to Matthias Karrasch, MD, Institute of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. Tel: +49 3641 9 325073; e-mail:

Received 3 May, 2019

Accepted 17 May, 2019

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