重症患者の呼吸道におけるヘルペス・シンプレックスウイルス:前向きな研究
Peggy Bruynseels1, Philippe G Jorens, Hendrik E Demey
1Department of Microbiology, University Hospital of Antwerp, Antwerp, Belgium. peggy.bruynseels@uza.be
Lancet (London, England)
|November 15, 2003
まとめ
上部呼吸道におけるヘルペス・シンプレックスウイルス (HSV) の再活性化は,集中治療室の患者に一般的です. 上呼吸道HSVは下呼吸道感染のリスクを高め,潜在的にアスピレーションを通じて発生する可能性があります.
科学分野:
- クリティカルケア医療は,重症治療薬です.
- ウイルス学 ウイルス学 ウイルス学
- 感染症 感染症は感染症です.
背景:
- 集中治療室 (ICU) の患者の下呼吸道にヘルペス・シンプレックスウイルス (HSV) の存在が認められているが,その臨床的意義は不明である.
- 重症患者の呼吸道におけるHSVの有病率,起源,危険因子,および臨床的関連性を調査するために,前向きなコホート研究が行われました.
研究 の 目的:
- ICU患者の呼吸道におけるHSVの有病率を決定する.
- 呼吸道におけるHSV検出に関連する危険因子を特定する.
- 重症患者のHSV存在に関連する臨床的関連性とアウトカムを評価する.
主な方法:
- ICUに入院した764人の患者から成るコホートは,呼吸道におけるHSV検査を前向きに行われました.
- HSVの存在を様々な臨床的変数とアウトカムと相関させるための統計的分析が行われました.
主要な成果:
- HSVは,ICU入院後10日以内に患者の22%の上部呼吸道 (口腔スランプ) で検出されました.
- HSVは,サンプリングされた患者の16%で下呼吸道から隔離されました.
- 上呼吸道HSVは下呼吸道HSV感染 (p<0.001) の有意な危険因子であり,重症,急性呼吸器不全症候群,およびICUでの長期滞在 (p<0.001) と関連していました.
結論:
- 高呼吸道におけるHSV再活性化または感染は,ICUの患者で頻繁に見られます.
- 上呼吸器のHSVは,下呼吸器のHSV感染を発症させる危険因子として機能し,おそらく吸入経由である.
- これらの発見は,重症患者のHSVを認識し,潜在的に管理することの臨床的重要性を強調しています.
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