Active cytomegalovirus infection in mechanically ventilated patients with sepsis

Abstract Background 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 lac...

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Main Authors: Zhihui Zhang, Jierong Zhang, Shuang Dai, Xueying Fan, Yuhua Liu, Junlu Sun, Lisheng Chen, Tiantian Song, Shangzuo Li, Jinjiang Zhang, Xuesong Liu, Rong Zhang, Dongdong Liu, Yonghao Xu, Yimin Li, Xiaoqing Liu
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-024-10304-4
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author Zhihui Zhang
Jierong Zhang
Shuang Dai
Xueying Fan
Yuhua Liu
Junlu Sun
Lisheng Chen
Tiantian Song
Shangzuo Li
Jinjiang Zhang
Xuesong Liu
Rong Zhang
Dongdong Liu
Yonghao Xu
Yimin Li
Xiaoqing Liu
author_facet Zhihui Zhang
Jierong Zhang
Shuang Dai
Xueying Fan
Yuhua Liu
Junlu Sun
Lisheng Chen
Tiantian Song
Shangzuo Li
Jinjiang Zhang
Xuesong Liu
Rong Zhang
Dongdong Liu
Yonghao Xu
Yimin Li
Xiaoqing Liu
author_sort Zhihui Zhang
collection DOAJ
description Abstract Background 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. Methods 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. Results 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). Conclusions 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.
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spelling doaj-art-14a01e894d084027b8edaf5ca3fc3c912025-08-20T02:31:37ZengBMCBMC Infectious Diseases1471-23342024-12-0124111010.1186/s12879-024-10304-4Active cytomegalovirus infection in mechanically ventilated patients with sepsisZhihui Zhang0Jierong Zhang1Shuang Dai2Xueying Fan3Yuhua Liu4Junlu Sun5Lisheng Chen6Tiantian Song7Shangzuo Li8Jinjiang Zhang9Xuesong Liu10Rong Zhang11Dongdong Liu12Yonghao Xu13Yimin Li14Xiaoqing Liu15Department 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityDepartment 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 UniversityAbstract Background 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. Methods 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. Results 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). Conclusions 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.https://doi.org/10.1186/s12879-024-10304-4Active cytomegalovirus infectionSepsisImmunocompetentMechanical ventilationClinical characteristics
spellingShingle Zhihui Zhang
Jierong Zhang
Shuang Dai
Xueying Fan
Yuhua Liu
Junlu Sun
Lisheng Chen
Tiantian Song
Shangzuo Li
Jinjiang Zhang
Xuesong Liu
Rong Zhang
Dongdong Liu
Yonghao Xu
Yimin Li
Xiaoqing Liu
Active cytomegalovirus infection in mechanically ventilated patients with sepsis
BMC Infectious Diseases
Active cytomegalovirus infection
Sepsis
Immunocompetent
Mechanical ventilation
Clinical characteristics
title Active cytomegalovirus infection in mechanically ventilated patients with sepsis
title_full Active cytomegalovirus infection in mechanically ventilated patients with sepsis
title_fullStr Active cytomegalovirus infection in mechanically ventilated patients with sepsis
title_full_unstemmed Active cytomegalovirus infection in mechanically ventilated patients with sepsis
title_short Active cytomegalovirus infection in mechanically ventilated patients with sepsis
title_sort active cytomegalovirus infection in mechanically ventilated patients with sepsis
topic Active cytomegalovirus infection
Sepsis
Immunocompetent
Mechanical ventilation
Clinical characteristics
url https://doi.org/10.1186/s12879-024-10304-4
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