Ann Lab Med 2017; 37(2): 129-136  
Automated Nucleic Acid Extraction Systems for Detecting Cytomegalovirus and Epstein-Barr Virus Using Real-Time PCR: A Comparison Study Between the QIAsymphony RGQ and QIAcube Systems
Hanah Kim, M.D.1, Mina Hur, M.D.1, Ji Young Kim, M.T.1, Hee-Won Moon, M.D.1, Yeo-Min Yun, M.D.1, and Hyun Chan Cho, M.D.2
Department of Laboratory Medicine1, Konkuk University School of Medicine, Seoul; Department of Laboratory Medicine2, Hallym University College of Medicine, Seoul, Korea
Correspondence to: Mina Hur
Department of Laboratory Medicine, Konkuk University School of Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea
Tel: +82-2-2030-5581 Fax: +82-2-2636-6764 E-mail:
Received: August 18, 2016; Revised: October 21, 2016; Accepted: November 17, 2016; Published online: March 1, 2017.
© The Korean Society for Laboratory Medicine. All rights reserved.

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Background: Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are increasingly important in immunocompromised patients. Nucleic acid extraction methods could affect the results of viral nucleic acid amplification tests. We compared two automated nucleic acid extraction systems for detecting CMV and EBV using real-time PCR assays.
Methods: One hundred and fifty-three whole blood (WB) samples were tested for CMV detection, and 117 WB samples were tested for EBV detection. Viral nucleic acid was extracted in parallel by using QIAsymphony RGQ and QIAcube (Qiagen GmbH, Germany), and real-time PCR assays for CMV and EBV were performed with a Rotor-Gene Q real-time PCR cycler (Qiagen). Detection rates for CMV and EBV were compared, and agreements between the two systems were analyzed.
Results: The detection rate of CMV and EBV differed significantly between the QIAsymphony RGQ and QIAcube systems (CMV, 59.5% [91/153] vs 43.8% [67/153], P=0.0005; EBV, 59.0% [69/117] vs 42.7% [50/117], P=0.0008). The two systems showed moderate agreement for CMV and EBV detection (kappa=0.43 and 0.52, respectively). QIAsymphony RGQ showed a negligible correlation with QIAcube for quantitative EBV detection. QIAcube exhibited EBV PCR inhibition in 23.9% (28/117) of samples.
Conclusions: Automated nucleic acid extraction systems have different performances and significantly affect the detection of viral pathogens. The QIAsymphony RGQ system appears to be superior to the QIAcube system for detecting CMV and EBV. A suitable sample preparation system should be considered for optimized nucleic acid amplification in clinical laboratories.
Keywords: Cytomegalovirus, Epstein-Barr virus, QIAsymphony RGQ, QIAcube, Nucleic acid, Extraction, Performance

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