cytomegalovirus reactivation and associated outcome of critically ill patients with severe sepsis巨细胞病毒激活和相关危重严重脓毒症患者的结果.pdfVIP

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cytomegalovirus reactivation and associated outcome of critically ill patients with severe sepsis巨细胞病毒激活和相关危重严重脓毒症患者的结果.pdf

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cytomegalovirus reactivation and associated outcome of critically ill patients with severe sepsis巨细胞病毒激活和相关危重严重脓毒症患者的结果

Heininger et al. Critical Care 2011, 15:R77 /content/15/2/R77 RESEARCH Open Access Cytomegalovirus reactivation and associated outcome of critically ill patients with severe sepsis 1 1* 2,3 4 5 6 Alexandra Heininger , Helene Haeberle , Imma Fischer , Robert Beck , Reimer Riessen , Frank Rohde , 3 4 7 1 4 Christoph Meisner , Gerhard Jahn , Alfred Koenigsrainer , Klaus Unertl and Klaus Hamprecht Abstract Introduction: Sepsis has been identified as a risk factor for human cytomegalovirus (CMV) reactivation in critically ill patients. However, the contribution of CMV reactivation on morbidity and mortality is still controversial. Therefore, we analyzed the incidence and impact of CMV reactivation on outcome in patients with severe sepsis. Methods: In a prospective longitudinal double-blinded observational study, 97 adult nonimmunosuppressed CMV- seropositive patients with new onset of severe sepsis were included. Leukocytes, plasma and tracheal secretions were examined weekly for CMV-DNA by PCR. Tracheal secretions were additionally tested for HSV (Herpes Simplex Virus)-DNA. The influence of CMV-reactivation on the endpoints was analysed by Cox proportional-hazard regression analysis. Time-dependency was evaluated by landmark analysis. Results: Six out 97 died and five were discharged from the hospital within 72 hours and were excluded of the analysis. CMV reactivation occurred in 35 of the 86 (40.69%) analysed patients. HSV infection occurred in 23 of the 35 (65.7%) CMV reactivators. In 10 patients CMV-plasma-DNAemia appeared with a DNA-content below 600 cop