Skip to main content

Table 1 Characteristics of studies assessing the rate and outcome of cytomegalovirus infection in critically ill patients

From: Cytomegalovirus infection in critically ill patients: a systematic review

    

CMV infection

Outcome CMV positive vs. negative

Study

Inclusion criteria

Number of patients

CMV IgGa

Frequency of monitoring

Assay (specimen)

Ratea

Time to positivity, dayb

Mortality, death/total (%)

ICU stay, dayb

[13]

ICU, mediastinitis after cardiac surgery

115

22/78 (28)

Every 3 weeks

Culture (blood, urine)

29/115 (25)

37 ± 22c

16/29 (55) vs. 31/86 (36) (NS)

69 ± 36 vs. 48 ± 27 (P < 0.05)

     

Culture (blood)

23/115 (20)

   

[6]

ICU, sepsis

60

33/44 (75)

Once

Culture, antigenemia, PCR (blood)

43/44 (98)

ND

ND

ND

[14]

ICU, mechanical ventilation

23

23/23 (100)

Randomd

PCR, culture (blood)

0/23 (0)

NA

NA

NA

    

Randome

PCR, culture (BAL)

0/14 (0)

   

[17]f

SICU, postoperative sepsis with no identifiable sources

142

ND

Once, day 30 ± 5g

Culture (blood, sputum, BAL)

12/142 (8.5)

NA

8/12 (66) vs. 45/130 (35)

ND

[7]

ICU, sepsis

34

31/33 (94)

Twice weekly

PCR (blood)

11/34 (32)

4 (1–23)

7/11 (64) vs. 17/23 (74) (NS)

ND

     

Antigenemia

6/34 (18)

11 (1–23)

  

[12]

ICU, ≥ 2 organ failures

48

ND

Once, day 1.8 ± 2.2b

PCR (blood)

1/48 (2.1)

NA

1/1 (100) vs. 15/47 (32) (NS)

ND

     

Antigenemia

0/48 (0)

   

[10]

ICU, SAPS II ≥ 41

56

56/56 (100)

Every week

PCR (blood, LRT secretions)

20/56 (36)

11

11/20 (55) vs. 13/36 (36) (NS)

30 vs. 23 (P = 0.0375)

     

PCR (blood)

18/56 (32)

   
     

Culture (LRT secretions)

7/56 (13)

   
     

Culture (blood)

0/56 (0)

   

[15]

ICU

120

ND

Once, day 4

PCR (blood)

1/120 (0.8)

NA

ND

ND

[8]

SICU stay ≥ 5 days

104

76/104 (73)

Every week

Culture (blood, LRT secretions)

10/104 (10)

28 ± 4g

5/10 (50) vs. 25/94 (27) (NS)

41 vs. 19 (P = 0.001)

     

Culture (blood)

6/104 (5.8)

   

[18]

ICU, fever > 72 hours without evidence of bacteriologic or fungal origin

237

ND

Clinical judgment

Antigenemia

40/237 (17)

20 ± 12

20/40 (50) vs. 11/40 (28) (P = 0.02)

41 ± 28 vs. 31 ± 22 (P = 0.04)

[16]

ICU stay ≥ 7 days, septic shock

25

25/25 (100)

Twice weekly in week 1, then every week

Antigenemia

8/25 (32)

7 (0–14)

5/8 (63) vs. 6/17 (35) (NS)

42 (16–87) vs. 18 (10–42) (P = 0.0025)

     

Culture (blood, LRT secretions, urine)

4/25 (16)

   
     

Culture (blood)

1/25 (4)

   

[11]

ICUh

120

120/120 (100)

Three times weekly

PCR (blood)

39/120 (33)

12 (3–57)

CMV viremia at any level is associated with continued ICU hospitalization or death at day 30 (OR 5.7, 95% CI 2.1–15.6)

 

[9]

ICU stay ≥ 14 days

99

41/56 (73)

Randomi

PCR (blood)

35/99 (35)j

17 ± 15

10/35 (29) vs. 7/64 (11) (P = 0.048)

33 ± 19 vs. 22 ± 11 (P < 0.001)

  1. BAL = bronchoalveolar lavage; CI = confidence interval; CMV = cytomegalovirus; ICU = intensive care unit; LRT = lower respiratory tract; NA = not applicable; ND = no data available; NS = not significant; OR = odds ratio; PCR = polymerase chain reaction; SAPS = simplified acute physiologic score; SICU = surgical intensive care unit.
  2. a Data were presented as positive/total (%).
  3. b Data were presented as mean ± standard deviation or median (range) unless otherwise indicated.
  4. c Time was measured after heart surgery.
  5. d Blood was collected at a mean of five days for the first sample and 17 days (range: 6 to 29 days) for the others.
  6. e BAL was performed at a mean of 19 days (range: 1 to 41 days).
  7. f Data were presented as combined outcomes of patients with CMV or herpes simplex virus infection in the original article. Data regarding CMV infection were extracted for this review.
  8. g Data were presented as mean ± standard error of mean.
  9. h This included admission to the burn ICU with at least 40% body surface burn or at least 20% body surface burn with inhalation injury, to the trauma ICU with in Injury Severity Score > 15 and > 4 unit packed red blood cells within 24 hours, to the medical ICU with suspected or documented sepsis, or to the cardiac care ICU with a diagnosis of acute myocardial infarction.
  10. i Blood was collected randomly and was stored for red blood cell cross-matching. The first blood samples were drawn on day 6.6 ± 8.2, and the last blood samples were drawn on day 20 ± 16.
  11. j 23 of 41 (56%) CMV seropositive patients developed CMV infection.
Back to article page

Critical Care

ISSN: 1364-8535