Cook C H, Yenchar J K, Kraner T O, Davies E A, Ferguson R M
Ohio State University Department of Surgery, Columbus, USA.
Am J Surg. 1998 Oct;176(4):357-60. doi: 10.1016/s0002-9610(98)00205-0.
Effects of cytomegalovirus (CMV) or herpes simplex virus (HSV) infection on surgical intensive care unit (SICU) patients' hospital outcome are unknown.
Between July 1, 1994, and September 1, 1995, general SICU patients with persistent sepsis and no bacterial or fungal source identifiable had viral cultures obtained. Patients with positive broncho-alveolar lavage, blood, skin, or sputum cultures for CMV or HSV were studied.
Twenty eligible patients had positive viral cultures during the study period, and 85% of these patients developed subsequent bacterial and/or fungal infections. Mortality was significantly higher following viral infection than in chronic SICU patients (65% vs 35%, P <0.006). Patients with thrombocytopenia complicating their viral infection had significantly higher mortality than those without thrombocytopenia (92% vs 25%, P <0.004).
At least 14% of critically ill surgical patients have occult infection or reactivation of herpes family viruses. These viruses have known immunosuppressive effects, which may predispose chronic SICU patients to subsequent bacterial and fungal infection, and subsequent organ system failure and death.
巨细胞病毒（CMV）或单纯疱疹病毒（HSV）感染对外科重症监护病房（SICU）患者的住院结局的影响尚不清楚。
在1994年7月1日至1995年9月1日期间，对患有持续性脓毒症且未发现细菌或真菌来源的普通SICU患者进行病毒培养。对支气管肺泡灌洗、血液、皮肤或痰液中CMV或HSV培养阳性的患者进行研究。
在研究期间，20例符合条件的患者病毒培养呈阳性，其中85%的患者随后发生细菌和/或真菌感染。病毒感染后的死亡率显著高于慢性SICU患者（65%对35%，P<0.006）。病毒感染合并血小板减少症的患者死亡率显著高于无血小板减少症的患者（92%对25%，P<0.004）。
至少14%的重症外科患者存在疱疹病毒家族的隐匿感染或再激活。这些病毒具有已知的免疫抑制作用，这可能使慢性SICU患者易发生随后的细菌和真菌感染，以及随后的器官系统衰竭和死亡。
