Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor outcome in critically ill patients
Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor outcome in critically ill patients
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DOI：
10.1007/s00134-008-1231-4
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发表时间：
2008-12-01
影响因子：
38.9
通讯作者：
Smismans, Annick
中科院分区：
文献类型：
--
作者：
Linssen, Catharina F. M.;Jacobs, Jan A.;Smismans, Annick
目的：评价BAL液中HSV-1和-2载量与临床预后的关系。回顾性研究。马斯特里赫特大学医院的普通重症监护室。纳入462例患者的521份BALF样本。患者分为三组；(1)入院时间<灌洗前48 h的患者（Community）；(2)入院时间<灌洗前48 h的患者（ICU）；(3)其余患者（非ICU组）。没有进行其他干预。采用实时聚合酶链反应（real-time polymerase chain reaction， PCR）检测HSV-1和HSV-2的载量。社区组标本检出HSV-1 DNA的比例为4.3%(4/92)，非ICU组标本检出HSV-1 DNA的比例为15% (18/121)，ICU组标本检出HSV-1 DNA的比例为32%（99/308）。在< 50岁年龄组中，HSV-1 DNA的分离频率低于50岁年龄组(分别为16/129（12%）和187/376 (25%),OR = 2.6；P < 0.001)。与携带10(5)个基因组当量(ge)/ml的单纯疱疹病毒1载量的患者相比，携带10(5)个基因组当量(ge)/ml的患者与14天住院死亡率增加相关，这加强了其临床相关性，有必要启动随机医学干预研究。
To evaluate the relationship between the HSV-1 and -2 loads in BAL fluid (BALF) and clinical outcome.Retrospective study.The general intensive care unit of the University Hospital Maastricht.Five hundred and twenty-one BALF samples from 462 patients were included. Patients were divided into three groups; (1) patients admitted to the hospital < 48 h before lavage (Community), (2) patients admitted to the ICU > 48 h before lavage (ICU) and (3) the remaining patients (non-ICU group).No additional interventions were conducted.HSV-1 and HSV-2 loads were determined by real-time polymerase chain reaction (PCR). HSV-1 DNA was detected in 4.3% (4/92) of samples in the community group, 15% (18/121) in the non-ICU group and in 32% (99/308) of the ICU group. In the age group < 50 years HSV-1 DNA was less frequently isolated compared to the age group 50 years (16/129 (12%) versus 187/376 (25%), respectively, OR = 2.6; P < 0.001). HSV-1 loads of >10(5) genome equivalents (ge)/ml were associated with an increased 14-day in-hospital mortality compared to patients with a HSV-1 load 10(5) ge/ml enforces its clinical relevance and necessitates to start randomized medical intervention studies.