The impact of cytomegalovirus infection on mechanically ventilated patients in the respiratory and geriatric intensive care units

The impact of cytomegalovirus infection on mechanically ventilated patients in the respiratory and geriatric intensive care units

Nehad M. Osmana, , , Nehad M. Sayedb, Safaa M. Abdel-Rahmanb, Sarah A. Hamzac, Ashraf A. Abd al azizd

Egyptian Journal of Chest Diseases and Tuberculosis Volume 63, Issue 1, January 2014, Pages 239–245

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doi:10.1016/j.ejcdt.2013.09.022

Background

Reactivation of cytomegalovirus (CMV) has been reported in critically ill patients (especially elderly) lying in the intensive care units. So identifying such patients to treat is important.

The aim of this study

To detect the frequency of CMV infection in mechanically ventilated patients, and its correlation with patients’ risk factors, and outcomes.

Subjects and methods

The present study was carried out on 51 mechanically ventilated patients admitted to the Respiratory (20) and Geriatric ICU (31) of the Ain Shams University hospitals over a 3 month period. Serum CMV load was measured by real-time PCR.

Results

The overall rate of active CMV infection by RT-PCR among the studied populations was (68.6%), (77.4%) in patients of geriatric ICU versus (55%) in respiratory ICU patients. Comparison between CMV positive and negative cases showed a significant difference in the duration of mechanical ventilation and mortality rate. A statistically higher CMV load was recorded in respiratory ICU patients admitted due to exacerbation of chronic respiratory disease or stroke and developing ventilator associated pneumonia (VAP) or septic shock. Also there was a significant direct correlation between CMV load and age of the patient, duration of mechanical ventilation and duration of ICU stay.

Conclusion

CMV infection is frequent in mechanically ventilated critically ill patients especially the elderly. It is associated with poor outcomes, leads to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections.

Keywords

Cytomegalovirus; Intensive care; Critical care; Ventilator; Sepsis; Critically ill

http://www.sciencedirect.com/science/article/pii/S0422763813002148