PMID- 18679655
OWN - NLM
STAT- MEDLINE
DCOM- 20090324
LR  - 20211020
IS  - 0342-4642 (Print)
IS  - 0342-4642 (Linking)
VI  - 34
IP  - 12
DP  - 2008 Dec
TI  - Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor 
      outcome in critically ill patients.
PG  - 2202-9
LID - 10.1007/s00134-008-1231-4 [doi]
AB  - OBJECTIVE: To evaluate the relationship between the HSV-1 and -2 loads in BAL 
      fluid (BALF) and clinical outcome. DESIGN: Retrospective study. SETTING: The 
      general intensive care unit of the University Hospital Maastricht. PATIENTS: 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). INTERVENTIONS: No 
      additional interventions were conducted. MEASUREMENTS AND RESULTS: 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 >or=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 
      <or=10(5) ge/ml in BALF (41 vs. 20%, respectively, P = 0.001). HSV-1 pneumonia 
      was histologically proven in two patients with a HSV-1 load exceeding 10(5) 
      ge/ml. CONCLUSIONS: HSV-1 occurred more in critically ill patients and high loads 
      in BALF were associated with an increased mortality. The higher mortality 
      observed in patients with HSV-1 load >10(5) ge/ml enforces its clinical relevance 
      and necessitates to start randomized medical intervention studies.
FAU - Linssen, Catharina F M
AU  - Linssen CF
AD  - Department of Medical Microbiology, University Hospital Maastricht, P.O. Box 
      5800, 6202 AZ, Maastricht, The Netherlands. klin@lmib.azm.nl
FAU - Jacobs, Jan A
AU  - Jacobs JA
FAU - Stelma, Foekje F
AU  - Stelma FF
FAU - van Mook, Walther N K A
AU  - van Mook WN
FAU - Terporten, Peter
AU  - Terporten P
FAU - Vink, Cornelis
AU  - Vink C
FAU - Drent, Marjolein
AU  - Drent M
FAU - Bruggeman, Cathrien A
AU  - Bruggeman CA
FAU - Smismans, Annick
AU  - Smismans A
LA  - eng
PT  - Journal Article
DEP - 20080805
PL  - United States
TA  - Intensive Care Med
JT  - Intensive care medicine
JID - 7704851
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bronchoalveolar Lavage Fluid/*virology
MH  - *Critical Illness
MH  - Female
MH  - Herpes Simplex/*mortality
MH  - Herpesvirus 1, Human/*isolation & purification
MH  - Herpesvirus 2, Human/isolation & purification
MH  - *Hospital Mortality
MH  - Humans
MH  - Intensive Care Units/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Netherlands/epidemiology
MH  - Odds Ratio
MH  - Pneumonia, Viral/*mortality/virology
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Viral Load
MH  - Young Adult
EDAT- 2008/08/06 09:00
MHDA- 2009/03/25 09:00
CRDT- 2008/08/06 09:00
PHST- 2007/10/11 00:00 [received]
PHST- 2008/07/11 00:00 [accepted]
PHST- 2008/08/06 09:00 [pubmed]
PHST- 2009/03/25 09:00 [medline]
PHST- 2008/08/06 09:00 [entrez]
AID - 10.1007/s00134-008-1231-4 [doi]
PST - ppublish
SO  - Intensive Care Med. 2008 Dec;34(12):2202-9. doi: 10.1007/s00134-008-1231-4. Epub 
      2008 Aug 5.