Anest. intenziv. Med. 2018;29(5):275-282

Cytomegalovirus infection in intensive care. Treat or ignore them?Intesive Care Medicine - Review Article

T. Karvunidis1,2,*, T. Reischig1,2, M. Matějovič1,2
1 I. interní klinika, Lékařská fakulta v Plzni, Univerzita Karlova a Fakultní nemocnice Plzeň
2 Biomedicínské centrum, Lékařská fakulta v Plzni, Univerzita Karlova

Cytomegalovirus (CMV) reactivation, infection and associated organ dysfunction in immunocompetent critically ill patients is getting into the intensivists' focus. Although the causal relationship between CMV reactivation and unfavorable outcomes has not been confirmed yet, observational evidence suggests a strong association with higher mortality, prolonged organ support and length-of-stay in intensive care. In addition to these relatively direct consequences, affected patients are more susceptible to the development of nosocomial infections, potentially as a result of complex immunomodulation of the host caused by CMV reactivation. Epidemiology, pathophysiology, clinical manifestation, treatment and prevention of selected herpesviruses in the immunocompetent patients are summarized in the presented review.

Keywords: cytomegalovirus; infection; immunocompetency; intensive care

Received: May 31, 2018; Accepted: September 4, 2018; Published: October 1, 2018  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Karvunidis T, Reischig T, Matějovič M. Cytomegalovirus infection in intensive care. Treat or ignore them? Anest. intenziv. Med. 2018;29(5):275-282.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Ljungman P, Boeckh M, Hirsch HH, et al. Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. 2017;64:87-91. Go to original source... Go to PubMed...
    2. Limaye AP, Kirby KA, Rubenfeld GD, et al. Cytomegalovirus reactivation in critically ill immunocompetent patients. JAMA. 2008;300:413-422. Go to original source... Go to PubMed...
    3. Ziemann M, Sedemund-Adib B, Reiland P, et al. Increased mortality in long-term intensive care patients with active cytomegalovirus infection. 2008;36:3145-3150. Go to original source... Go to PubMed...
    4. Sinclair J. Human cytomegalovirus: latency and reactivation in the myeloid lineage. J Clin Virol. 2008;41:180-185. Go to original source... Go to PubMed...
    5. Ong DSY, Spitoni C, Klein Klouwenberg PMC, et al. Cytomegalovirus reactivation and mortality in patients with acute respiratory distress syndrome. Intensive Care Med. 2016;42:333-341. Go to original source... Go to PubMed...
    6. Mansfield S, Griessl M, Gutknecht M, et al. Sepsis and cytomegalovirus: foes or conspirators? Med Microbiol Immunol. 2015;204:431-437. Go to original source... Go to PubMed...
    7. Papazian L, Hraiech S, Lehingue S, et al. Cytomegalovirus reactivation in ICU patients. Intensive Care Med. 2016;42:28-37. Go to original source... Go to PubMed...
    8. Bate SL, Dollar SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clin Infect Dis. 2010;50:1439-1447. Go to original source... Go to PubMed...
    9. Gandhi MK, Khanna R. Human cytomegalovirus: clinical aspects, immune regulation, and emerging treatments. Lancet Infect Dis. 2004;4:725-738. Go to original source... Go to PubMed...
    10. Xiao W, Mindrinos MN, Seok J, et al. A genomic storm in critically injured humans. J Exp Med. 2011;208:2581-2590. Go to original source... Go to PubMed...
    11. Delano MJ, Ward PA. Sepsis-induced immune dysfunction: can immune therapies reduce mortality? J Clin Invest. 2016;126:23-31. Go to original source... Go to PubMed...
    12. Kalil AC, Florescu DF. Prevalence and mortality associated with cytomegalovirus infection in nonimmunosuppressed patients in the intensive care unit. Crit Care Med. 2009;37:2350-2358. Go to original source... Go to PubMed...
    13. Heininger A, Haeberle H, Fischer I, et al. Cytomegalovirus reactivation and associated outcome of critically ill patients with severe sepsis. Crit Care. 2011;15:R77. Go to original source... Go to PubMed...
    14. Balthesen M, Messerle M, Reddehase MJ. Lungs are a major site of cytomegalovirus latency and recurrence. J Virol. 1993;67:5360-5366. Go to original source... Go to PubMed...
    15. Toorkey CB, Carrigan DR. Immunohistochemical detection of an immediate early antigen of human cytomegalovirus in normal tissues. J Infect Dis. 1989;160:741-751. Go to original source... Go to PubMed...
    16. Sylwester AW, Mitchell BL, Edgar JB, et al. Broadly targeted human cytomegalovirus-specific CD4+ and CD8+ T cells dominate the memory compartments of exposed subjects. J Exp Med. 2005;202:673-758. Go to original source... Go to PubMed...
    17. Moss P. The emerging role of cytomegalovirus in driving immune senescence: a novel therapeutic opportunity for improving health in the eldery. Curr Opin Immunol. 2010;22:529-534. Go to original source... Go to PubMed...
    18. Solana R, Tarazona R, Aiello AE. CMV and immunosenescence: from basics to clinics. Immun Ageing. 2012;9:23. Go to original source... Go to PubMed...
    19. McCormic AL. Control of apoptosis by human cytomegalovirus. Curr Top Mircobiol Immunol. 2008;325:281-295. Go to original source... Go to PubMed...
    20. Powers C, DeFilippis V, Malouli D, et al. Cytomegalovirus immune evasion. Curr Top Microbiol Immunol. 2008;325:333-359. Go to original source... Go to PubMed...
    21. Wilkinson GW, Tomasec P, Stanton RJ, et al. Modulation of natural killer cells by human cytomegalovirus. J Clin Virol. 2008;41:206-212. Go to original source... Go to PubMed...
    22. Slobedman B. Virus-encoded homologs of cellular inter-leukin-10 and their control of host immune response. J Virol. 2009;83:9618-9629. Go to original source... Go to PubMed...
    23. Noda S, Aguirre SA, Bitmansour A, et al. Cytomegalovirus MCK-2 controls mobilization and recruitment of myeloid progenitor cells to facilitate dissemination. Blood. 2006;107:30-38. Go to original source... Go to PubMed...
    24. Vomaske J, Melynchuk RM, Smith PP, et al. Differential ligand binding to a human cytomegalovirus chemokine receptor determines cell type-specific motility. PLoS Pathol. 2009;5:e1000304. Go to original source... Go to PubMed...
    25. Osawa R, Singh N. Cytomegalovirus infection in critically ill patients: a systematic review. Crit Care. 2009;13:R68. Go to original source... Go to PubMed...
    26. Seckert CK, Griessl M, Buettner JK, et al. Viral latency drives "memory inflation": a unifying hypothesis linking two hallmarks cytomegalovirus infection. Med Microbiol Immunol. 2012;201:551-566. Go to original source... Go to PubMed...
    27. Campbell J, Trgovcich J, Kincaid M. Transient CD8-memory contraction: a potential contributor to latent cytomegalovirus reactivation. J Leukoc Biol. 2012;92:933-937. Go to original source... Go to PubMed...
    28. Vogel T, Vadonis R, Kuehn J, et al. Viral reactivation is not related to septic complications after major surgical resections. APMIS. 2008;116:292-301. Go to original source... Go to PubMed...
    29. Frantzeskaki FG, Karampi ES, Kottaridi C, et al. Cytomegalovirus reactivation in a general, nonimmunosuppressed intensive care unit population: incidence, risk factors, associations with organ dysfunction, and inflammatory biomarkers. J Crit Care. 2015;30:276-81. Go to original source... Go to PubMed...
    30. Kalil AC, Levitsky J, Lyden E, et al. Meta-analysis: the efficacy of strategiesto prevent organ disease by cytomegalovirus in solid organ transplant recipients. Ann Intern Med. 2005;143:870-880. Go to original source... Go to PubMed...
    31. Al-Omari A, Aljamaan F, Alhazzani W, et al. Cytomegalovirus infection in immunocompetent critically ill adults: literature review. Ann Intensive Med. 2016;6:110. Go to original source... Go to PubMed...
    32. Lisboa LF, Preiksaitis JK, Humar A, et al. Clinical utility of molecular surveillance for cytomegalovirus after antiviral prophylaxis in high-risk solid organ transplant recipients. Transplantation. 2011;92:1063-1068. Go to original source... Go to PubMed...
    33. Crough T, Khanna R. Immunobiology of human cytomegalovirus: from bench to bedside. Clin Microbiol Rev. 2009;22:76-98. Go to original source... Go to PubMed...
    34. Chiche L, Forel JM, Thomas G, et al. Interferon-γ production by natural killer cells and cytomegalovirus in critically ill patients. Crit Care Med. 2012;40:3162-3169. Go to original source... Go to PubMed...
    35. Cantisán S, Lara R, Montejo M, et al. Pretransplant interferon-γ secretion by CMV-specific CD8+ T cells informs the risk of CMV replication after transplantation. Am J Transplant. 2013;13:738-745. Go to original source... Go to PubMed...
    36. Mattes FM, Vargas A, Kopycinski J, et al. Functional impairment of cytomegalovirus specific CD8 T cells predicts high-level replication after renal transplantation. Am J Transplant. 2008;8:990-999. Go to original source... Go to PubMed...
    37. Castón JJ, Catisán S, González-Gasca F, et al. Interferon-γ production by CMV-specific CD8+ T lymphocytes provides protection against cytomegalovirus reactivation in critically ill patients. Intensive Care Med. 2016;42:46-53. Go to original source... Go to PubMed...
    38. Kotton CN, Kumar D, Caliendo AM, et al. Updated interna-tional consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation. 2013;96:330-360. Go to original source... Go to PubMed...
    39. Durand CM, Marr KA, Arnold CA, et al. Detection of cytomegalovirus DNA in plasma as an adjunct diagnostic for gastrointestinal tract disease in kidney and liver transplant recipients. Clin Infect Dis. 2013;57:1550-1559. Go to original source... Go to PubMed...
    40. Goodman AL, Murray CD, Watkins J, et al. CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis. Eur J Clin Microbiol Infect Dis. 2015;34:13-18. Go to original source... Go to PubMed...
    41. Razonable RR, Humar A. Cytomegalovirus in solid organ transplantation. Am J Transplant. 2013;13:93-106. Go to original source... Go to PubMed...
    42. Torre-Cisneros J, Aguado JM, Caston JJ, et al. Management of cytomegalovirus infection in solid organ transplantrecipients: SET/GESITRA-SEIMC/REIPI recommendations. Transplant Rev. 2016;30:119-143. Go to original source... Go to PubMed...
    43. Fernández-Ruiz M, Munos-Codoceo C, López-Medrano F, et al. Cytomegalovirus myoperikarditis and hepatitis in an immunocompetent adult: successful treatment with oral valganciclovir. Intern Med. 2008;47:1963-1966. Go to original source... Go to PubMed...
    44. Forel JM, Martin-Loeches I, Luyt CE. Treating HSV and CMV reactivations in critically ill patients who are not immunocompromized: pro. Intensive Care Med. 2014;40:1945-1949. Go to original source... Go to PubMed...
    45. Chanques G, Jaber S. Treating HSV and CMV reactivations in critically ill patients who are not immunocompromized: con. Intensive Care Med. 2014;40:1950-1953. Go to original source... Go to PubMed...
    46. Limaye AP, Stapleton RD, Peng L, et al. Effect of ganciclovir on IL-6 levels among cytomegalovirus-seropositive adults with critical illness: a randomized clinical trial. JAMA. 2017;318:731-740. Go to original source... Go to PubMed...
    47. Cowley NJ, Owen A, Schiels SC, et al. Safety and efficacy of antiviral therapyfor prevention of cytomegalovirus reactivation in immunocompetent critically ill patients: a randomized clinical trial. JAMA Intern Med. 2017;177:774-783. Go to original source... Go to PubMed...
    48. Chiche L, Forel JM, Roch A, et al. Active cytomegalovirus infection is common in mechanically ventilated medical intensive care unit patients. Crit Care Med. 2009;37:1850-1857. Go to original source... Go to PubMed...
    49. Kalil AC, Florescu DF. Is cytomegalovirus reactivation increasing the mortality of patients with severe sepsis? Crit Care. 2011;15:138. Go to original source... Go to PubMed...
    50. Humar A, Kumar D, Boivin G, et al. Cytomegalovirus (CMV) virus load kinetics to predict recurrent disease in solid-organ transplant patients with CMV disease. J Infect Dis. 2002;186:829-833. Go to original source... Go to PubMed...

    Return to the content


    Anesteziologie a intenzivní medicína

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.