title: Cytomegalovirus serostatus and outcome in nonimmunocompromised critically ill patients.
abstract: OBJECTIVE
  The impact of cytomegalovirus reactivation during critical illness remains unclear and studies investigating prophylaxis in cytomegalovirus seropositive patients are being considered. This study investigates the association between cytomegalovirus seropositivity and outcome in a large population of nonimmunocompromised critically ill patients.
  
  
  METHODS
  Cytomegalovirus serostatus was determined on prospectively collected serum samples. The primary end point was intensive care unit mortality. The secondary end points were in-hospital mortality, time to alive discharge from intensive care unit and hospital, time to alive weaning from mechanical ventilation, and need for renal replacement therapy.
  
  
  METHODS
  This retrospective study was performed in a 17-bed medical and 56-bed surgical intensive care unit in a 1,900-bed referral hospital.
  
  
  METHODS
  We analyzed serum of 1,504 nonimmunocompromised critically ill patients with an intensive care unit length of stay of 3 days or more. Patients with hematologic malignancy, transplantation, immunosuppressive therapy (calcineurin inhibitors, antitumor necrosis factor-α drugs, antilymphocyte antibodies, or chemotherapeutic agents), or a do-not-resuscitate order were excluded.
  
  
  METHODS
  None.
  
  
  RESULTS
  Sixty-four percent of the studied patients were cytomegalovirus seropositive. Multivariable analysis revealed no associated risk for intensive care unit or hospital mortality, or for time to alive discharge from intensive care unit or hospital. The risk for alive weaning from mechanical ventilation and the need for renal replacement therapy were also comparable in seropositive and seronegative groups.
  
  
  CONCLUSIONS
  : No association was found between the cytomegalovirus serostatus and the studied major clinical outcomes. Based on these results, the design of an intervention study assessing the impact of cytomegalovirus prophylaxis in all cytomegalovirus seropositive critically ill patients appears premature.
authors.affiliation: Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium. Greet.devlieger@uzleuven.be
authors.forename: Greet
authors.initials: G
authors.lastname: De Vlieger
authors.forename: Wouter
authors.initials: W
authors.lastname: Meersseman
authors.forename: Katrien
authors.initials: K
authors.lastname: Lagrou
authors.forename: Pieter
authors.initials: P
authors.lastname: Wouters
authors.forename: Alexander
authors.initials: A
authors.lastname: Wilmer
authors.forename: Willy E
authors.initials: WE
authors.lastname: Peetermans
authors.forename: Greet
authors.initials: G
authors.lastname: Van den Berghe
authors.forename: Eric
authors.initials: E
authors.lastname: Van Wijngaerden
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D016638:Critical Illness / Q000401:mortality; D003586:Cytomegalovirus Infections / Q000150:complications*; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D015300:Ventilator Weaning / Q000706:statistics & numerical data