title: Clinical significance of a positive serology for mimivirus in patients presenting a suspicion of ventilator-associated pneumonia.
abstract: OBJECTIVE
  A seroconversion to mimivirus has been observed in patients with community-acquired or nosocomial pneumonia. The aim of this study was to determine whether a positive serology for mimivirus was associated with increased morbidity and mortality in patients with a suspicion of ventilator-associated pneumonia (VAP).
  
  
  METHODS
  Prospective matched-cohort study.
  
  
  METHODS
  A 12-bed medical intensive care unit (ICU) in a teaching hospital.
  
  
  METHODS
  Patients ventilated for at least 2 days presenting with a suspicion of VAP. Patients with a positive serology for mimivirus were matched to seronegative patients.
  
  
  METHODS
  None.
  
  
  RESULTS
  Matching criteria were: 1) the same main diagnosis on ICU admission, 2) the same age (+/- 10 yrs), 3) the same Simplified Acute Physiology II score (+/-10 points), 4) the same McCabe and Jackson comorbidity score, 5) admission within 1 year, and 6) diagnosis of at least one bacterial VAP during the ICU stay or not. A total of 55 pairs were submitted for analysis. The effectiveness of matching was 94.8%. Patients with a positive serology for mimivirus had longer duration of mechanical ventilation and ICU stay with median excesses of 7 days and 10 days, respectively. There was no difference in ICU mortality. The duration of mechanical ventilation before bronchoalveolar lavage (adjusted odds ratios [OR]1.08, p = 0.02), viral identification other than mimivirus during ICU stay (adjusted OR 0.32, p = 0.05), and enteral nutrition (adjusted OR 0.13, p = 0.01) were associated with positive serology for mimivirus.
  
  
  CONCLUSIONS
  A positive serology for mimivirus is associated with a poorer outcome in mechanically ventilated ICU patients.
authors.affiliation: Service de Réanimation Médicale, Hôpital Sainte-Marguerite, Université de la Méditerranée, Marseille, France.
authors.forename: Agnès
authors.initials: A
authors.lastname: Vincent
authors.forename: Bernard
authors.initials: B
authors.lastname: La Scola
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Forel
authors.forename: Vanessa
authors.initials: V
authors.lastname: Pauly
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
authors.forename: Laurent
authors.initials: L
authors.lastname: Papazian
mesh_terms: D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D004267:DNA Viruses / Q000276:immunology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000097:blood / Q000453:epidemiology* / Q000821:virology*; D011446:Prospective Studies; D012698:Serologic Tests; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral