Human cytomegalovirus infections in nonimmunosuppressed critically ill patients

Abstract

Even in a group of ICU patients without manifest immunodeficit who were anti-HCMV IgG seropositive and had reached a SAPS II score of >or=41 points, active HCMV infection occurred frequently (35.6%). Septic patients were affected twice as often as the total study population. In 2 of the 20 cases, active HCMV infection progressed to severe HCMV disease. Proper diagnosis demands special clinical attention combined with extended virological examinations. Further studies in a larger patient group should evaluate the influence of HCMV on ICU mortality.

Cytomegalovirus infection in non-immunosuppressed critically ill patients

“…CMV reactivation in apparently immunocompetent individuals with critical illness is becoming an area of emerging clinical significance. It has been observed that CMV infection occurs in critically sick patients admitted in ICUs and the prevalence ranges from 0-35% [12][13][14][15][16][17]. This wide variation observed in different studies is due to different study designs, limited sample size, lack of standardized diagnostic criteria, inclusion of only selected types of ICU patients, different inclusion and exclusion criteria, and/or failure to include comprehensive and rigorous statistical analysis.…”

“…Many studies have shown the importance of CMV infection in such patients [12][13][14][15][16][17]. Presence of CMV infection in critically ill ICU patients led to increased length of ICU stay and increased duration of mechanical ventilation as compared to patients negative for CMV infections even when both the groups had similar disease severity [8,12,13] Nosocomial infections were also significantly higher in patients positive for CMV as compared to non CMV patients [15]. The rates of renal failure and steroid therapy were also higher in CMV positive groups [8,14].…”

“…CMV infected patients also had higher mortality as compared to CMV negative patients [12,15]. Thus many different studies have highlighted the importance of CMV infection in ICU patients [8,[12][13][14][15][16][17].…”

“…Contrary to the traditional belief that CMV infection in immunocompetent but critically ill patients follows a self-limited course, are considerable investigations that report increased morbidity and mortality as a result of CMV in such cases [12][13][14][15][16][17].…”

A flow cytometry-based method for detecting antibody responses to murine cytomegalovirus infection

“…Episodes of reactivation are known to be pathogenic in immunosuppressed populations, such as AIDS patients or transplant recipients (Simmons et al, 1977;Spector et al, 1998). Recent studies in previously immunocompetent critically ill patients have also suggested pathogenicity (Cook et al, 2003;Cook et al, 1998;Curtsinger et al, 1989;Cushing et al, 1993;Heininger et al, 2001;Heininger et al, 2000;Jaber et al, 2005;Papazian et al, 1996). Because of its pathogenic implications, the mechanism by which CMV reactivation occurs has received considerable attention.…”