title: A Prospective Monitoring Study of Cytomegalovirus Infection in Non-Immunosuppressed Critical Heart Surgery Patients.
abstract: BACKGROUND
  Reactivation of cytomegalovirus (CMV) has been reported occasionally in immnunocompetent patients in the intensive care unit (ICU). The epidemiology and association of CMV infection with adverse outcome is not well defined in this population. Patients undergoing major heart surgery (MHS) are at a particularly high risk of infection. CMV infection has not been systematically monitored in MSH-ICU patients.
  
  
  METHODS
  We assessed CMV plasma viremia weekly using a quantitative polymerase chain reaction assay in a prospective cohort of immunocompetent adults admitted to the MHS-ICU for at least 72 hours between October 2012 and May 2013. Risk factors for CMV infection and its potential association with continued hospitalization or death by day 30 (composited endpoint) were assessed using univariate and multivariate logistic regression analyses.
  
  
  RESULTS
  CMV viremia at any level was recorded in 16.5% of patients at a median of 17 days (range, 3-54 days) after admission to the MHS-ICU. Diabetes (adjusted OR, 5.6; 95% CI, 1.8-17.4; p=0.003) and transfusion requirement (>10 units) (adjusted OR, 13.7; 95% CI, 3.9-47.8; p<0.001) were independent risk factors associated with CMV reactivation. Reactivation of CMV at any level was independently associated with the composite endpoint (adjusted OR, 12.1; 95% CI, 2.3-64; p=0.003).
  
  
  CONCLUSIONS
  Reactivation of CMV is relatively frequent in immunocompetent patients undergoing MHS and is associated with prolonged hospitalization or death.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Lopez Roa
authors.affiliation: Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain; Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Maria Jesus
authors.initials: MJ
authors.lastname: Perez-Granda
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Munoz
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Catalan
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Alonso
authors.affiliation: Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sanchez-Perez
authors.affiliation: Department of Anesthesiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: Emma
authors.initials: E
authors.lastname: Novoa
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense, Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000821:virology*; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology