Increased mortality in long-term intensive care patients with active cytomegalovirus infection*

Ziemann, Malte; Sedemund-Adib, Beate; Reiland, Petra; Schmucker, P.; Hennig, Holger

doi:10.1097/ccm.0b013e31818f3fc4

Cited by 74 publications

(67 citation statements)

References 27 publications

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“…Based on the author's knowledge, this high prevalence of HHV6 among HHVs is not reported by other prospective studies on ventilated pediatric patients at the PICU. Although there was no significant differences between clinical outcome (mortality) in VAP+/HHV+ and VAP+/HHVgroups (P value: 0.326), yet patients with positive HHVs had greater mortality (24.7%), which is in agreement with previous reports (13,21,(41)(42)(43)(44)(45). On the other hand, patients with VAP (+) had a greater chance of HHVs positivity (36.8%) than VAP (-) patients (18.7%) (P value = 0.124) (34).…”

Section: Discussionsupporting

confidence: 82%

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Amanati

Karimi

Fahimzad

et al. 2018

Arch Pediatr Infect Dis

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Background: Critically ill children at the intensive care unit frequently develop hospital-acquired pneumonia (HAP). Human herpes viruses (HHVs), primarily or by reactivation may cause bronchopneumonitis in mechanically ventilated patients. The exact prevalence and role of HHVs in morbidity and mortality of pediatric patients undergoing mechanical ventilation is unclear. The current study was conducted to evaluate the prevalence of 5 Herpes viruses by polymerase chain reaction (PCR) method in bronchoalveolar lavage (BAL) samples in critically ill children at a pediatric intensive care unit (PICU). Methods: Overall, 140 bronchoalveolar lavage samples from 83 mechanically ventilated cases were studied. Samples were taken via the mini-BAL technique. Samples were analyzed by qualitative PCR for detection of herpes simplex virus type 1 and 2 (HSV1/HSV2), human herpes virus type 6 and 7 (HHV6/HHV7), Ebstein-Barr virus (EBV), and cytomegalovirus (CMV).

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Section: Discussionsupporting

confidence: 82%

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Amanati

Karimi

Fahimzad

et al. 2018

Arch Pediatr Infect Dis

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“…The incidence and clinical relevance of active CMV infection in critically ill patients without canonical immunosuppression have been assessed in a number of studies [Domart et al, 1990;Stéphan et al, 1996;Cook et al, 1998Cook et al, , 2003Kutza et al, 1998;Heininger et al, 2001;Jaber et al, 2005;Von Mü ller et al, 2006;Limaye et al, 2008;Ziemann et al, 2008;Chiche et al, 2009;Kalil and Florescu, 2009;Osawa and Singh, 2009]. Nevertheless, little is known about the natural course of CMV reactivation in this clinical setting.…”

Section: Discussionmentioning

confidence: 97%

Virological and immunological features of active cytomegalovirus infection in nonimmunosuppressed patients in a surgical and trauma intensive care unit

Chilet

Aguilar

Benet

et al. 2010

Journal of Medical Virology

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Cytomegalovirus (CMV) reactivation occurs frequently in critically ill patients. The natural course of CMV infection and the interaction between CMV and the adaptive immune system in this setting remain poorly defined. Fifty‐three CMV‐seropositive patients in a surgical and trauma intensive care unit were included in this study. The CMV DNA load in tracheal aspirates (TA) and plasma (PL) was monitored by qPCR. CMV‐specific T‐cell immunity was assessed by intracellular cytokine staining. Plasma TNF‐α levels were determined by ELISA. CMV reactivation occurred in 39.7% of patients (23% had CMV DNA detected only in TA). The analysis of TA allowed an earlier diagnosis in 28% of patients. Clearance of CMV DNAemia preceded that of CMV DNA in TA in some episodes. Peak CMV DNA levels were significantly higher in TA than in PL (P = 0.02). CMV reactivation developed in the presence of CMV‐specific T cells. Termination of CMV reactivation was associated with an expansion of functional CMV‐specific T cells. Plasma levels of TNF‐α did not allow for the prediction of the occurrence of CMV reactivation. CMV‐specific T‐cell immunity is preserved in most critically ill patients experiencing CMV reactivation. Analysis of respiratory specimens is imperative for an optimal monitoring of CMV reactivation in this setting. J. Med. Virol. 82:1384–1391, 2010. © 2010 Wiley‐Liss, Inc.

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“…In the last decade the role of serious infections in activation of latent HCMV infection in immunocompetent patients also is being scrutinised. The studies comprised critically ill patients treated at intensive care units (ICU) [4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Presence of human cytomegalovirus DNA in blood of patients with community-acquired pneumonia

Saletinger

Poljak

Strle

2015

Clinical Microbiology and Infection

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After a primary infection, human cytomegalovirus (HCMV) remains latent in certain human cells. Different stimuli, including immune deficiency and severe infection, can trigger the reactivation of latent HCMV infection. In the last decade, the role of the reactivation in immunocompetent patients with serious illness has been intensely studied; however, the knowledge of the potential role of moderately severe infections on HCMV dynamics is limited. In the prospective study, 80 HCMV-seropositive, immunocompetent adult patients with community-acquired pneumonia (CAP), treated outside the intensive care unit (ICU), were monitored with real-time polymerase chain reaction (PCR) for the presence of HCMV DNA. Detection of HCMV DNA in whole blood and/or plasma was interpreted as reactivation of latent HCMV infection. HCMV DNA was detected in 6 of 80 (7.5%) patients. All HCMV DNA-positive patients were classified according to the pneumonia severity index (PSI) as high-risk classes IV or V; thus, HCMV DNAaemia rate within these two PSI classes was 16.7%. All of the patients had positive whole blood samples, whereas plasma samples were positive in a single patient. We did not detect any significant differences comparing six patients with proven HCMV DNAaemia and 74 patients in whom HCMV DNAaemia was not demonstrated regarding the levels of inflammatory parameters on admission, length of treatment with supplemental oxygen, and length of hospital stay. In conclusion, the finding of HCMV DNAaemia in patients with CAP treated outside the ICU is a rare event and occurs only in patients with PSI classes designating more severe pneumonia.

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Increased mortality in long-term intensive care patients with active cytomegalovirus infection*

Abstract: Active cytomegalovirus infection is a frequent but seldom diagnosed finding in surgical patients with prolonged intensive care unit stay, which is associated with increased mortality and prolonged intensive care unit stay of surviving patients.

Cited by 74 publications

References 27 publications

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit

Virological and immunological features of active cytomegalovirus infection in nonimmunosuppressed patients in a surgical and trauma intensive care unit

Presence of human cytomegalovirus DNA in blood of patients with community-acquired pneumonia

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