Skip to main content
NCBI home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1992 Nov;30(11):2822–2825. doi: 10.1128/jcm.30.11.2822-2825.1992

Cytomegalovirus (CMV) antigenemia assay is more sensitive than shell vial cultures for rapid detection of CMV in polymorphonuclear blood leukocytes.

A Erice 1, M A Holm 1, P C Gill 1, S Henry 1, C L Dirksen 1, D L Dunn 1, R P Hillam 1, H H Balfour Jr 1
PMCID: PMC270535  PMID: 1333479

Abstract

We compared the cytomegalovirus (CMV) antigenemia assay with shell vial cultures of polymorphonuclear leukocyte (PMNL)-enriched blood fractions for rapid diagnosis of CMV viremia. PMNL fractions of 280 blood specimens from 171 patients (170 solid-organ transplant recipients and 1 patient undergoing pretransplant evaluation) were inoculated in shell vial and conventional CMV cultures. A commercially available kit (CMV-vue kit; INCSTAR Corp.) was used for the CMV antigenemia assay, in which PMNL preparations were stained with monoclonal antibodies directed against the CMV protein pp65. Mixed-leukocyte blood fractions from the same blood specimens were inoculated in parallel shell vial and conventional cultures. CMV viremia (defined by the isolation of CMV in conventional cultures) was detected in 32 (13%) of 245 PMNL fractions included in the final analysis. Twenty-eight (87.5%) were also positive in the CMV antigenemia assay, whereas 22 (69%) were positive in shell vial cultures. Ten (4%) additional PMNL fractions positive only in the CMV antigenemia assay were from eight patients with active CMV infections (six patients), who had previous or subsequent episodes of CMV viremia (seven patients), or in whom CMV was isolated in cultures of simultaneously obtained mixed-leukocyte fractions (three patients). Overall, the CMV antigenemia assay was significantly more sensitive than shell vial cultures for detection of CMV in the PMNL fraction of blood leukocytes (P < 0.01, McNemar's test), and we recommend it as the method of choice for rapid diagnosis of CMV viremia.

Full text

PDF
2822

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arens M., Owen J., Hagerty C. M., Reed C. A., Storch G. A. Optimizing recovery of cytomegalovirus in the shell vial culture procedure. Diagn Microbiol Infect Dis. 1991 Mar-Apr;14(2):125–130. doi: 10.1016/0732-8893(91)90046-i. [DOI] [PubMed] [Google Scholar]
  2. Dankner W. M., McCutchan J. A., Richman D. D., Hirata K., Spector S. A. Localization of human cytomegalovirus in peripheral blood leukocytes by in situ hybridization. J Infect Dis. 1990 Jan;161(1):31–36. doi: 10.1093/infdis/161.1.31. [DOI] [PubMed] [Google Scholar]
  3. Gerna G., Parea M., Percivalle E., Zipeto D., Silini E., Barbarini G., Milanesi G. Human cytomegalovirus viraemia in HIV-1-seropositive patients at various clinical stages of infection. AIDS. 1990 Oct;4(10):1027–1031. doi: 10.1097/00002030-199010000-00014. [DOI] [PubMed] [Google Scholar]
  4. Gerna G., Revello M. G., 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. J Clin Microbiol. 1992 May;30(5):1232–1237. doi: 10.1128/jcm.30.5.1232-1237.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gerna G., Zipeto D., Parea M., Revello M. G., 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. J Infect Dis. 1991 Sep;164(3):488–498. doi: 10.1093/infdis/164.3.488. [DOI] [PubMed] [Google Scholar]
  6. Gleaves C. A., Lee C. F., Kirsch L., Meyers J. D. Evaluation of a direct fluorescein-conjugated monoclonal antibody for detection of cytomegalovirus in centrifugation culture. J Clin Microbiol. 1987 Aug;25(8):1548–1550. doi: 10.1128/jcm.25.8.1548-1550.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Goodrich J. M., Mori M., Gleaves C. A., Du Mond C., Cays M., Ebeling D. F., Buhles W. C., DeArmond B., Meyers J. D. Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplantation. N Engl J Med. 1991 Dec 5;325(23):1601–1607. doi: 10.1056/NEJM199112053252303. [DOI] [PubMed] [Google Scholar]
  8. Howell C. L., Miller M. J., Martin W. J. Comparison of rates of virus isolation from leukocyte populations separated from blood by conventional and Ficoll-Paque/Macrodex methods. J Clin Microbiol. 1979 Oct;10(4):533–537. doi: 10.1128/jcm.10.4.533-537.1979. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jacobson M. A., Mills J. Serious cytomegalovirus disease in the acquired immunodeficiency syndrome (AIDS). Clinical findings, diagnosis, and treatment. Ann Intern Med. 1988 Apr;108(4):585–594. doi: 10.7326/0003-4819-108-4-585. [DOI] [PubMed] [Google Scholar]
  10. Meyers J. D., Flournoy N., Thomas E. D. Risk factors for cytomegalovirus infection after human marrow transplantation. J Infect Dis. 1986 Mar;153(3):478–488. doi: 10.1093/infdis/153.3.478. [DOI] [PubMed] [Google Scholar]
  11. Meyers J. D., Ljungman P., Fisher L. D. Cytomegalovirus excretion as a predictor of cytomegalovirus disease after marrow transplantation: importance of cytomegalovirus viremia. J Infect Dis. 1990 Aug;162(2):373–380. doi: 10.1093/infdis/162.2.373. [DOI] [PubMed] [Google Scholar]
  12. Paya C. V., Wold A. D., Smith T. F. Detection of cytomegalovirus infections in specimens other than urine by the shell vial assay and conventional tube cell cultures. J Clin Microbiol. 1987 May;25(5):755–757. doi: 10.1128/jcm.25.5.755-757.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Peterson P. K., Balfour H. H., Jr, Marker S. C., Fryd D. S., Howard R. J., Simmons R. L. Cytomegalovirus disease in renal allograft recipients: a prospective study of the clinical features, risk factors and impact on renal transplantation. Medicine (Baltimore) 1980 Jul;59(4):283–300. [PubMed] [Google Scholar]
  14. Revello M. G., 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. J Med Virol. 1989 Oct;29(2):88–93. doi: 10.1002/jmv.1890290204. [DOI] [PubMed] [Google Scholar]
  15. Salmon D., Lacassin F., Harzic M., Leport C., Perronne C., Bricaire F., Brun-Vezinet F., Vilde J. L. Predictive value of cytomegalovirus viraemia for the occurrence of CMV organ involvement in AIDS. J Med Virol. 1990 Nov;32(3):160–163. doi: 10.1002/jmv.1890320306. [DOI] [PubMed] [Google Scholar]
  16. Saltzman R. L., Quirk M. R., Jordan M. C. Disseminated cytomegalovirus infection. Molecular analysis of virus and leukocyte interactions in viremia. J Clin Invest. 1988 Jan;81(1):75–81. doi: 10.1172/JCI113313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schirm J., Timmerije W., van der Bij W., The T. H., Wilterdink J. B., Tegzess A. M., van Son W. J., Schröder F. P. Rapid detection of infectious cytomegalovirus in blood with the aid of monoclonal antibodies. J Med Virol. 1987 Sep;23(1):31–40. doi: 10.1002/jmv.1890230105. [DOI] [PubMed] [Google Scholar]
  18. The T. H., van der Bij W., van den Berg A. P., van der Giessen M., Weits J., Sprenger H. G., van Son W. J. Cytomegalovirus antigenemia. Rev Infect Dis. 1990 Sep-Oct;12 (Suppl 7):S734–S744. [PubMed] [Google Scholar]
  19. Turtinen L. W., Saltzman R., Jordan M. C., Haase A. T. Interactions of human cytomegalovirus with leukocytes in vivo: analysis by in situ hybridization. Microb Pathog. 1987 Oct;3(4):287–297. doi: 10.1016/0882-4010(87)90062-3. [DOI] [PubMed] [Google Scholar]
  20. van den Berg A. P., Klompmaker I. J., Haagsma E. B., Scholten-Sampson A., Bijleveld C. M., Schirm J., van der Giessen M., Slooff M. J., The T. H. Antigenemia in the diagnosis and monitoring of active cytomegalovirus infection after liver transplantation. J Infect Dis. 1991 Aug;164(2):265–270. doi: 10.1093/infdis/164.2.265. [DOI] [PubMed] [Google Scholar]
  21. van der Bij W., Schirm J., Torensma R., van Son W. J., Tegzess A. M., The T. H. Comparison between viremia and antigenemia for detection of cytomegalovirus in blood. J Clin Microbiol. 1988 Dec;26(12):2531–2535. doi: 10.1128/jcm.26.12.2531-2535.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES