Cytomegalovirus and Epstein–Barr virus reactivation in the intensive care unit

Autor: Bulent Ahmet Besirbellioglu, Selim Kilic, E. Yazici, M. Tekin, Ahmet Karakaş, F. Şahiner, Cumhur Artuk, Omer Coskun, L. Yamanel
Rok vydání: 2016
Předmět:
Adult
Male
Epstein-Barr Virus Infections
Herpesvirus 4
Human
medicine.medical_specialty
medicine.medical_treatment
Congenital cytomegalovirus infection
Cytomegalovirus
Enzyme-Linked Immunosorbent Assay
Emergency Nursing
Critical Care and Intensive Care Medicine
law.invention
03 medical and health sciences
0302 clinical medicine
Risk Factors
law
Internal medicine
Anesthesiology
Internal Medicine
medicine
Humans
030212 general & internal medicine
Prospective cohort study
Epstein–Barr virus infection
Aged
Aged
80 and over
Mechanical ventilation
APACHE II
business.industry
Immunologic Deficiency Syndromes
030208 emergency & critical care medicine
Middle Aged
Viral Load
medicine.disease
Intensive care unit
Intensive Care Units
C-Reactive Protein
Cytomegalovirus Infections
Immunology
Emergency Medicine
Female
Virus Activation
business
Immunocompetence
Viral load
Zdroj: Medizinische Klinik - Intensivmedizin und Notfallmedizin. 112:239-245
ISSN: 2193-6226
2193-6218
DOI: 10.1007/s00063-016-0198-0
Popis: The purpose of this work was to evaluate the reactivation of cytomegalovirus (CMV) and Epstein–Barr virus (EBV) in immunocompetent patients in the intensive care unit (ICU) and to identify risk factors associated with reactivation. In this observational prospective study, 60 adult immunocompetent patients who stayed at least 7 days in an ICU were evaluated. During hospitalization, the viral load was monitored at admission and on day 7 with polymerase chain reaction to detect viral reactivation and weekly thereafter on days 14, 21, and 28 if hospitalization continued. The mean age of patients was 63.3 years (±23.4 years) and 34 (56.7 %) of them were male. Mean APACHE II scores for patients was 25 at admission. Of these patients, 28 were hospitalized in the internal ICU and 32 were hospitalized in the anesthesiology ICU. CMV/EBV reactivation was found in 17 individuals (12 for EBV, 3 for CMV, and 2 for both). The median high-sensitive C-reactive protein value in patients with CMV reactivation was significantly higher than in those patients without CMV reactivation (p = 0.037). EBV reactivation was statistically higher in patients with mechanical ventilation compared to patients without mechanical ventilation (p = 0.023). EBV reactivation in patients with fever was found to be statistically higher than in the patients without fever (p = 0.035). There is a need for extended studies with a larger number of patients from specific groups to better understand the reactivation frequency and identify risk factors. EBV and CMV reactivation should be taken into consideration in critically ill patients with fever, without specific symptoms and unresponsive to the treatment.
Databáze: OpenAIRE
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