Positive Epstein-Barr virus detection and mortality in respiratory failure patients admitted to the intensive care unit
Positive Epstein-Barr virus detection and mortality in respiratory failure patients admitted to the intensive care unit
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DOI：
10.1111/crj.12433
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发表时间：
2017-11-01
影响因子：
1.7
通讯作者：
Sun, Bing
中科院分区：
文献类型：
--
作者：
He, Hangyong;Wang, Yajing;Sun, Bing
背景EB病毒（Epstein-Barr virus，EBV）感染可通过多种途径诱导免疫抑制，从而影响宿主对其他病原体的正常反应，导致危重患者预后不良。所有因呼吸衰竭入住ICU的患者均纳入研究。EBV检测从下呼吸道（LRT）和血清样本常规performed.Results28例连续入住ICU高风险的感染或感染的临床体征被列入我们的研究。在28例患者中，15例EBV LRT阳性（53.6%），8例EBV血清学阳性（28.6%）。在LRT EBV阳性患者中，肺炎是ICU入院的主要指征（93.3%），在LRT EBV阴性患者中，COPD急性加重（AECOPD）是ICU入院的另一个指征（46.2%）。LRT和血清EBV阳性患者的CD 3 + T细胞计数（尤其是CD 3 + CD 8 + T细胞计数）低于正常范围; EBV阴性患者的这些计数在正常范围内。ICU死亡率为32.1%。EBV血清学阳性患者的死亡率明显高于血清学阴性患者（62.5%比20.0%）。LRT EBV阳性和阴性patients.ConclusionsThis研究表明，EB病毒DNA检测LRT和血清样本中的一个显着数量的ICU呼吸衰竭患者之间的任何结果参数没有显着差异，EBV血清阳性与死亡率。这一发现可能与低的CD 3 + CD 8 + T细胞计数有关。
BackgroundEpstein-Barr virus (EBV) infection may induce immune suppression in several ways, which may influence the proper host response to other pathogens and lead to a bad outcome of critically ill patients.MethodsThis was a single-center, retrospective, observational study. All patients admitted to an ICU because of respiratory failure were included. EBV detection from lower respiratory tract (LRT) and serum samples were routinely performed.ResultsTwenty-eight consecutive cases who were admitted to the ICU at high-risk for an infection or clinical signs of an infection were included in our study. Among the 28 patients, 15 were LRT-positive for EBV (53.6%), and 8 were seropositive for EBV (28.6%). Among the LRT EBV-positive patients, pneumonia was the main indication for ICU admission (93.3%), and in LRT EBV-negative patients, acute exacerbation of COPD (AECOPD) was another indication for ICU admission (46.2%). The CD3+ T cell count (especially the CD3+CD8+ T cell count) was lower than the normal range in LRT- and serum EBV-positive patients; these count were in the normal range in EBV-negative patients. The ICU mortality was 32.1% for all patients. The mortality rate was significantly higher in patients who were seropositive for EBV than seronegative patients (62.5% vs 20.0%). No differences were shown between any outcome parameters for LRT EBV-positive and -negative patients.ConclusionsThis study showed that EBV DNA is detected in LRT and serum samples of a significant number of ICU patients with respiratory failure, and seropositivity for EBV was associated with mortality. This finding maybe correlated with a low CD3+CD8+ T cell count.