title: Use of a modified shell vial technique to quantitate cytomegalovirus viremia in a population of solid-organ transplant recipients.
abstract: A quantitative modification of the shell vial assay was used to investigate cytomegalovirus viremia in solid-organ transplant recipients. The level of viremia detected in 109 of 407 specimens ranged from 0.02 to 28 infectious foci per 100,000 leukocytes. By using a Poisson model, a technique was developed to determine 95% confidence limits for the measured levels of viremia. These confidence limits were used to determine the level of viremia that could be excluded by culturing a given number of cells. Longitudinal assessment of two transplant recipients revealed different patterns of viremia and demonstrated that significant disease sometimes occurred with low-level viremia. On the basis of the results of the studies, culture of at least 4 x 10(6) leukocytes is recommended for the sensitive detection of cytomegalovirus viremia.
authors.affiliation: Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110.
authors.forename: R S
authors.initials: RS
authors.lastname: Buller
authors.forename: T C
authors.initials: TC
authors.lastname: Bailey
authors.forename: N A
authors.initials: NA
authors.lastname: Ettinger
authors.forename: M
authors.initials: M
authors.lastname: Keener
authors.forename: T
authors.initials: T
authors.lastname: Langlois
authors.forename: J P
authors.initials: JP
authors.lastname: Miller
authors.forename: G A
authors.initials: GA
authors.lastname: Storch
mesh_terms: D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D006801:Humans; D007962:Leukocytes / Q000382:microbiology*; D009894:Opportunistic Infections / Q000382:microbiology*; D016377:Organ Transplantation; D016012:Poisson Distribution; D014766:Viremia / Q000382:microbiology*; D014776:Virus Cultivation / Q000379:methods