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实时聚合酶链反应监测严重烧伤患者巨细胞病毒感染:一项前瞻性研究。

Cytomegalovirus infection in severe burn patients monitoring by real-time polymerase chain reaction: A prospective study.

机构信息

Burn Center, Sainte Anne Hospital, France.

出版信息

Burns. 2011 May;37(3):434-9. doi: 10.1016/j.burns.2010.11.006. Epub 2011 Jan 14.

Abstract

BACKGROUND

Cytomegalovirus (CMV) infection has been shown to occur not rarely in critically ill patients in the past decade. However, little data are available on CMV infection in burn patients whereas their susceptibility to CMV infection has been proved.

METHODS

We prospectively assessed CMV viremia by real-time polymerase chain reaction and clinical outcome in immunocompetent burn patients with total burn surface area greater than 15%.

RESULTS

Twenty-nine patients were enrolled. The rate of CMV infection was of 71% in CMV seropositive burn patients, and of 12.5% in CMV seronegative burn patients. CMV reactivation was associated with a higher IGS 2 score on admission. High grade CMV viremia was associated with longer mechanical ventilation duration, higher infection number, higher transfused red blood cell number, and longer ICU stays. There were no differences on mortality rate between patients with and without CMV reactivation.

CONCLUSION

CMV infection rate is considerable in burn patients with TBSA greater than 15%. This infection seems to be mostly due to reactivation of latently existing virus.

摘要

背景

过去十年间,大量重症患者出现巨细胞病毒(CMV)感染的情况。然而,有关烧伤患者 CMV 感染的数据却十分有限,尽管他们极易受到 CMV 感染。

方法

我们通过实时聚合酶链反应对免疫功能正常、烧伤总面积大于 15%的烧伤患者进行 CMV 血症检测,并对其临床结果进行前瞻性评估。

结果

共纳入 29 名患者。CMV 血清阳性烧伤患者的 CMV 感染率为 71%,CMV 血清阴性烧伤患者的 CMV 感染率为 12.5%。CMV 再激活与入院时较高的 IGS 2 评分相关。高等级 CMV 血症与较长的机械通气时间、更高的感染数量、更多的红细胞输注以及更长的 ICU 住院时间相关。CMV 再激活与无 CMV 再激活患者的死亡率无差异。

结论

烧伤面积大于 15%的烧伤患者 CMV 感染率相当高。这种感染似乎主要是由于潜伏病毒的再激活引起的。

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