Zhang Zhihui, Zhang Jierong, Dai Shuang, Fan Xueying, Liu Yuhua, Sun Junlu, Chen Lisheng, Song Tiantian, Li Shangzuo, Zhang Jinjiang, Liu Xuesong, Zhang Rong, Liu Dongdong, Xu Yonghao, Li Yimin, Liu Xiaoqing
Department of Critical Care Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China.
BMC Infect Dis. 2024 Dec 18;24(1):1405. doi: 10.1186/s12879-024-10304-4.
Active cytomegalovirus (CMV) infection is associated with poor prognosis in septic patients with critical illness. Patients of septic category are highly likely to benefit from prophylactic antiviral therapy. Nevertheless, the clinical characteristics for CMV reactivation are lacking among septic patients requiring mechanical ventilation. The aim of this study was to investigate the incidence, risk factors, and clinical outcomes regarding active CMV infection in mechanically ventilated patients with sepsis.
A single-center, retrospective cohort study conducted from January 2021 to December 2023 that included septic patients on mechanical ventilation at the intensive care unit (ICU) of a national hospital. Study participants were divided into active and non-active CMV infection groups based on CMV DNAemia within a 28-day hospitalization period in ICU. Clinical features, laboratory findings, treatment measures, and clinical outcomes were compared between the two groups.
Among 118 septic patients, 21 (17.8%) exhibited active CMV infection within 28-day ICU admission. Hemoglobin served as an independent risk factor and predictor for active CMV infection (P < 0.05). Moreover, the duration of mechanical ventilation and ICU stay in active CMV infection patients were significantly higher than in the comparison group (P < 0.05).
Active CMV infection is common and associated with adverse clinical outcomes in mechanically ventilated patients with sepsis. A low level of hemoglobin is an independent risk factor for active CMV infection. Further prospective studies are warranted to assess the efficacy of initiating prophylactic and preemptive antiviral therapies among patients with sepsis disorders.
活动性巨细胞病毒（CMV）感染与重症脓毒症患者的不良预后相关。脓毒症患者很可能从预防性抗病毒治疗中获益。然而，在需要机械通气的脓毒症患者中，缺乏CMV再激活的临床特征。本研究的目的是调查机械通气的脓毒症患者中活动性CMV感染的发生率、危险因素和临床结局。
一项单中心回顾性队列研究，时间跨度为2021年1月至2023年12月，纳入一家国立医院重症监护病房（ICU）接受机械通气的脓毒症患者。根据患者在ICU住院28天内的CMV血症情况，将研究参与者分为活动性CMV感染组和非活动性CMV感染组。比较两组的临床特征、实验室检查结果、治疗措施和临床结局。
在118例脓毒症患者中，21例（17.8%）在ICU入院28天内出现活动性CMV感染。血红蛋白是活动性CMV感染的独立危险因素和预测指标（P＜0.05）。此外，活动性CMV感染患者的机械通气时间和ICU住院时间显著长于对照组（P＜0.05）。
活动性CMV感染在机械通气的脓毒症患者中很常见，且与不良临床结局相关。低水平血红蛋白是活动性CMV感染的独立危险因素。有必要进行进一步的前瞻性研究，以评估对脓毒症患者启动预防性和抢先性抗病毒治疗的疗效。
