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Increased mortality in long-term intensive care patients with active cytomegalovirus infection

Malte Ziemann1, Beate Sedemund-Adib, Petra Reiland

  • 1Institute of Transfusion Medicine, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. ziemann@immu.mu-luebeck.de

Critical Care Medicine
|October 22, 2008
PubMed
Abstract

Insights

Active human cytomegalovirus infections are common in critically ill patients, often going undiagnosed. These infections increase mortality and prolong intensive care unit stays.

Area of Science:

  • Intensive Care Medicine
  • Infectious Diseases
  • Virology

Background:

  • Prolonged intensive care unit (ICU) stays are associated with various complications.
  • Human cytomegalovirus (CMV) reactivation can occur in critically ill patients.

Purpose of the Study:

  • To determine the prevalence of active human cytomegalovirus (CMV) infections in patients with prolonged ICU treatment.
  • To assess the impact of active CMV infections on patient outcomes.

Main Methods:

  • Retrospective analysis of stored plasma samples from 138 patients with prolonged ICU stays (≥14 days).
  • Testing for cytomegalovirus DNA using molecular methods.
  • Exclusion of immunocompromised patients and those with inconclusive results.

Main Results:

  • Active CMV infection was diagnosed in 35% (35/99) of immunocompetent patients with prolonged ICU stays.
  • CMV DNA was detected in 64/255 evaluable samples.
  • Patients with active CMV infection had significantly higher mortality (28.6% vs. 10.9%) and longer ICU stays (32.6 vs. 22.1 days).

Conclusions:

  • Active CMV infection is a frequent, yet underdiagnosed, complication in surgical patients with prolonged ICU stays.
  • Active CMV infection is associated with increased mortality and extended ICU duration.
  • Clinical diagnosis of active CMV infection in this setting is rare.

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