Document Detail


Increased mortality in long-term intensive care patients with active cytomegalovirus infection.
MedLine Citation:
PMID:  18936696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the prevalence and impact on patient outcome of active human cytomegalovirus infections in patients with prolonged treatment in an intensive care unit. DESIGN: Retrospective analysis of stored plasma samples. SETTING: Anesthesiological intensive care unit of a university hospital. PATIENTS: All 138 patients treated for at least 14 days (of a total of 4940 patients admitted during the study period). Immunocompromised patients and patients with inconclusive results for cytomegalovirus DNA were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Stored plasma samples of patients with prolonged intensive care unit stay were tested for cytomegalovirus DNA. Sixty-four of 255 evaluable samples from 99 immunocompetent patients tested cytomegalovirus DNA-positive with a mean DNA concentration of 8,600 genome equivalents per milliliter. Active cytomegalovirus infection was diagnosed by reproducibly positive results in 35 patients (35%). Only one case had been diagnosed clinically. Patients with and without active cytomegalovirus infection were not significantly different in parameters, such as age, sex, admission category, source of admission, or comorbidities. Even review of specific surgical procedures or the use of a heart-lung-machine showed no significant differences between the groups. The mortality rate in patients with cytomegalovirus infection was significantly increased (28.6% vs. 10.9%, p = 0.048), and surviving patients had a longer intensive care unit stay (32.6 vs. 22.1 days, p <0.001). CONCLUSIONS: 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.
Authors:
Malte Ziemann; Beate Sedemund-Adib; Petra Reiland; Peter Schmucker; Holger Hennig
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  36     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2008-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3145-50     Citation Subset:  AIM; IM    
Affiliation:
Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. ziemann@immu.mu-luebeck.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Cytomegalovirus / genetics
Cytomegalovirus Infections / diagnosis*,  mortality*
DNA, Viral / blood
Female
Hospitals, University
Humans
Intensive Care Units
Length of Stay
Male
Middle Aged
Prevalence
Retrospective Studies
Chemical
Reg. No./Substance:
0/DNA, Viral
Comments/Corrections
Comment In:
Crit Care Med. 2008 Dec;36(12):3261-4   [PMID:  19020435 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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