在重症儿童中发生细胞巨化病毒活跃感染
Sarah Cazella Schwab1, Aparecida Yulie Yamamoto2, Davi Casale Aragon1
1From the Department of Pediatrics, Division of Pediatric Critical Care Medicine.
The Pediatric infectious disease journal
|July 31, 2023
概括
在儿科重症监护病房的0.74%患者中发生了细胞巨乳病毒 (CMV) 活跃感染. 超过6的PELOD得分表明死亡风险更高,而CMV病毒载量没有预测死亡率.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 细胞巨乳病毒 (CMV) 是一种常见的病毒,在免疫功能低下的人群中可能导致严重疾病.
- 在儿科重症监护室 (PICU) 设置中的活跃CMV感染需要了解其流行病学和不良结果的风险因素.
研究的目的:
- 描述在PICU中患有活跃CMV感染的儿童的流行病学,临床特征和结果.
- 为了确定与这些儿科患者的死亡率相关的风险因素.
主要方法:
- 追溯队列研究,涉及在PICU期间通过PCR在血液或气管中检测到CMVDNA的患者.
- 排除未经确认的疑似病例和PICU前感染.
- 数据收集包括人口统计,临床细节和医疗记录的结果.
主要成果:
- 实验室确认的CMV活体感染的发生率在8年内4748名PICU入院者中为0.74%.
- 在35名患有CMV感染的儿童中,71.4%的免疫能力低下,31.4%的死亡.
- 死亡率与年龄较大 (中位数为65岁与5.5个月) 和抗病毒治疗持续时间较短 (中位数为12天与23天) 相关.
- 感染性休克是主要的死亡原因 (82%),而PELOD得分>6是死亡的重要危险因素 (RR 2.96).
- 血液中的CMV病毒载量显示出死亡率预测能力较差 (AUC 0.62).
结论:
- 在PICU中CMV活跃感染的发生率为0.74%,特别是在免疫受损的儿童中.
- 超过6的PELOD分数是患有CMV感染的儿科患者死亡的危险因素.
- 血液中的CMV病毒载量不是该人群中死亡率的可靠预测指标.
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