Abstract
To establish the number of blood samples necessary for the diagnosis of viremic episodes caused by cytomegalovirus (CMV), a prospective analysis was conducted of 238 patients (38 renal transplant recipients and 200 HIV-infected patients) who developed CMV viremia. The usefulness of samples and the volume of blood required to demonstrate the presence of viremia by CMV was also studied. The first blood sample was diagnostic for CMV viremia in 53.3% of the viremic patients; the second sample documented an additional 22.2% of cases of viremia (75.5% of infected patients); and the third sample demonstrated viremia in the remaining 24.5%. Thus, a diagnosis of CMV viremia was established in every patient (100% of episodes of viremia). In this study, the use of three 3 ml blood samples collected at 24 h intervals was sufficient to detect all episodes of CMV viremia in patients clinically suspected to have disseminated disease.
Similar content being viewed by others
References
Rubin RH: Infection in the renal and liver transplant patient. In: Rubin RH, Young LS (ed): Clinical approach to infection in the compromised host. Plenum Publishing, New York, 1988, p. 557–621.
Jacobson MA, Mills J: Serious cytomegalovirus disease in the acquired immunodeficiency syndrome (AIDS). Clinical findings, diagnosis, and treatment. Annals of Internal Medicine 1988, 108: 585–594.
Van der Bij W, Schrim J, Torensma R, Van Son J, Tegzess AM, The TH: Comparison between viremia and antigenemia for detection of cytomegalovirus in blood. Journal of Clinical Microbiology 1988, 26: 2531–2535.
Revello MG, Percivalle E, Zavattoni M, Parea M, Grossi P, Gerna G: Detection of human cytomegalovirus immediate-early antigen in leukocytes as a marker of viremia in immunocompromised patients. Journal of Medical Virology 1989, 29: 88–93.
Gerna G, Revello MG, Percivalle E, Morini F: Comparison of different immunostaining techniques and monoclonal antibodies to the lower matrix phosphoprotein (pp65) for optimal quantitation of human cytomegalovirus antigenemia. Journal of Clinical Microbiology 1992, 30: 1232–1237.
Gerna G, Zipeto D, Percivalle E, Parea M, Revello MG, Maccario R, Peri G, Milanesi G: Human cytomegalovirus infection of the major leukocyte subpopulations and evidence for initial viral replication in polymorphonuclear leukocytes from viremic patients. Journal of Infectious Diseases 1992, 166: 1236–1244.
Gerna G, Percivalle E, Revello MG, Morini F: Correlation of quantitative human cytomegalovirus pp65-, p72- and p150-antigenemia, viremia and circulating endothelial giant cells with clinical symptoms and antiviral treatment in immunocompromised patients. Clinical and Diagnostic Virology 1993, 1: 47–59.
Gerna G, Revello MG, Percivalle E, Zavattoni M, Parea M, Battaglia M: Quantification of human cytomegalovirus viremia by using monoclonal antibodies to different viral proteins. Journal of Clinical Microbiology 1990, 28: 2681–2688.
Gerna G, Zipeto D, Parea M, Revello MG, Silini E, Percivalle E, Zavattoni M, Grossi P, Milanesi G: Monitoring of human cytomegalovirus infections and ganciclovir treatment in heart transplant recipients by determination of viremia, antigenemia, and DNAemia. Journal of Infectious Diseases 1991, 164: 488–498.
Buller RS, Bailey TC, Ettinger NA, Keener M, Langlois T, Miller JP, Storch GA: Use of a modified shell vial technique to quantitate cytomegalovirus viremia in a population of solid-organ transplant recipients. Journal of Clinical Microbiology 1992, 30: 2620–2624.
Storch GA, Buller RS, Bailey TC, Ettinger NA, Langlois T, Gaudeault-Keener M, Welby PL: Comparison of PCR and pp65 antigenemia assay with quantitative shell vial culture for detection of cytomegalovirus in blood leukocytes from solid-organ transplant recipients. Journal of Clinical Microbiology 1994, 32: 997–1003.
Mazzulli T, Rubin RH, Ferraro MJ, D'Aquila RT, Doveikis SA, Smith BR, The TH, Hirsch MS: Cytomegalovirus antigenemia: clinical correlations in transplant recipients and in persons with AIDS. Journal of Clinical Microbiology 1993, 31: 2824–2827.
Bek B, Boeckh M, Lepeines J, Bieniek B, Arasteh K, Heise W, Deppermann KM, Bornhoft G, Stoffler-Meilicke M, Schuller I, Hoffken G: High-level sensitivity of quantitative pp65 cytomegalovirus (CMV) antigenemia assay for diagnosis of CMV disease in AIDS patients and follow-up. Journal of Clinical Microbiology 1996, 34: 457–459.
Pillay D, Ali AA, Liu SF, Kops E, Sweny P, Griffiths PD: Significance of positive CMV cultures during surveillance of renal transplant recipients. Transplantation 1993, 56: 103–108.
Paya CV, Wold AD, Ilstruk DM, Smith TF: Evaluation of number of shell vial cell cultures per clinical specimen for rapid diagnosis of cytomegalovirus infection. Journal of Clinical Microbiology 1988, 26: 198–200.
Arens M, Owen J, Hagerty CM, Reed CA, Storch GA: Optimizing recovery of cytomegalovirus in the shell vial culture procedure. Diagnostic Microbiology and Infectious Disease 1991, 14: 125–130.
Patel R, Klein DW, Espy MJ, Harmsen WS, Ilstrup DM, Paya CV, Smith TF: Optimization of detection of cytomegalovirus viremia in transplantation recipients by shell vial assay. Journal of Clinical Microbiology 1995, 33: 2984–2986.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Reina, J., Blanco, I. & Munar, M. Determination of the number of blood samples needed for optimal detection of cytomegalovirus viremia in immunocompromised patients using a shell-vial assay. Eur. J. Clin. Microbiol. Infect. Dis. 16, 318–321 (1997). https://doi.org/10.1007/BF01695639
Issue Date:
DOI: https://doi.org/10.1007/BF01695639