Viral infections in septic shock (VISS-trial)-crosslinks between inflammation and immunosuppression

• Verfasst von: Brenner, Thorsten [VerfasserIn]
• Verfasst von: Rosenhagen, Claudia [VerfasserIn]
• Verfasst von: Hornig, Isabelle [VerfasserIn]
• Verfasst von: Schmidt, Karsten [VerfasserIn]
• Verfasst von: Mieth, Markus [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Martin, Eike [VerfasserIn]
• Verfasst von: Schnitzler, Paul [VerfasserIn]
• Verfasst von: Hofer, Stefan [VerfasserIn]
• Titel: Viral infections in septic shock (VISS-trial)-crosslinks between inflammation and immunosuppression
• Verf.angabe: Thorsten Brenner, Claudia Rosenhagen, Isabelle Hornig, Karsten Schmidt, Christoph Lichtenstern, Markus Mieth, Thomas Bruckner, Eike Martin, Paul Schnitzler, Stefan Hofer, and Markus A. Weigand
• Jahr: 2012
• Umfang: 12 S.
• Fussnoten: Available online: 13 November 2011 ; Gesehen am 05.07.2018
• Titel Quelle: Enthalten in: Journal of surgical research
• Ort Quelle: Orlando, Fla. : Academic Press, 1961
• Jahr Quelle: 2012
• Band/Heft Quelle: 176(2012), 2, Seite 571-582
• ISSN Quelle: 1095-8673
• DOI: doi:10.1016/j.jss.2011.10.020
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: cytomegalovirus (CMV)
• Sach-SW: herpes simplex virus type 1 (HSV-1)
• Sach-SW: immunosuppression
• Sach-SW: inflammation
• Sach-SW: septic shock
• K10plus-PPN: 1577327845

Abstract

Background: Recent investigations provided evidence that herpes simplex virus (HSV-1) and cytomegalovirus (CMV) are reactivated in critically ill individuals. However, at this time, it remains unclear whether these viral infections are of real pathogenetic relevance or represent innocent bystanders. Materials and Methods: In total, 60 patients with septic shock were enrolled. Blood samples and tracheal secretion were collected at the time of sepsis diagnosis (T0) as well as 7 d (T1), 14 d (T2), 21 d (T3), and 28 d (T4) later. The following virologic diagnostics were performed: (1) Viral load of herpes simplex virus type1 (HSV-1) and cytomegalovirus (CMV) in blood samples as well as tracheal secretion using polymerase chain reaction (PCR). (2) Detection of CMV-antigen (pp65) in blood samples using immunofluorescence microscopy. Furthermore plasma levels of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were evaluated using ELISA-kits. Results: Thirty-one patients (51.7%) were found to be positive for HSV-1, whereas in 16 patients (26.7%) CMV could be identified. Patients with a positive PCR for HSV-1 and/or CMV showed a significantly prolonged length of hospital stay and absolute time of respirator-dependant ventilation. Furthermore, survival curves of patients with a high HSV-1-load (>10E8) in tracheal secretion in comparison with those with a lower HSV-1-load (<10E8) revealed a significantly impaired survival. Conclusions: Viral superinfections with HSV-1 or CMV can frequently be observed in patients with septic shock, especially in those with increased disease severity and a prolonged need for respirator-dependant ventilation. In patients with a viral superinfection morbidity is increased, whereas differences in mortality seem to be dosage-dependant.