gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Impact of herpes simplex virus detection in respiratory specimens of patients with suspected viral pneumonia / ARDS

Relevanz von Herpes simplex Virus DNA in respiratorischen Materialien bei Verdacht auf virale Pneumonie / ARDS

Meeting Abstract

  • S. Scheithauer - Krankenhaushygiene und Infektiologie, UK/RWTH Aachen, Germany
  • A.K. Manemann - Institut für Medizinische Mikrobiologie, UK/RWTH Aachen, Lehr- und Forschungsgebiet Virologie, Aachen, Germany
  • S. Krüger - Medizinische Klinik I, UK/RWTH Aachen, Sektion Pneumologie, Aachen, Germany
  • M.G. Häusler - Klinik für Kinder und Jugendmedizin, UK/RWTH Aachen, Germany
  • A. Krüttgen - Institut für Medizinische Mikrobiologie, UK/RWTH Aachen, Germany
  • S.W. Lemmen - Krankenhaushygiene und Infektiologie, UK/RWTH Aachen, Germany
  • K. Ritter - Institut für Medizinische Mikrobiologie, UK/RWTH Aachen, Lehr- und Forschungsgebiet Virologie, Aachen, Germany
  • M. Kleines - Institut für Medizinische Mikrobiologie, UK/RWTH Aachen, Lehr- und Forschungsgebiet Virologie, Aachen, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP106

DOI: 10.3205/10kit161, URN: urn:nbn:de:0183-10kit1611

Published: June 2, 2010

© 2010 Scheithauer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objectives: Respiratory infection and failure is a common problem in intensive care unit (ICU) patients. However, despite the accumulating body of evidence to suggest that herpes simplex virus (HSV) is associated with pneumonia, this virus' exact role in this process is still not fully understood. Therefore, to identify patients at risk, we conducted a case control study to characterize patients with HSV-positive pneumonia.

Patients and methods:Between 2007 and 2009, all patients with suspected viral pneumonia (N=191) were tested for the presence of herpesviruses using a PCR approach with respiratory specimens. To identify possible associations, risk factors, and impact of HSV, HSV-positive patients (N=51) were compared to age-, gender-, and department- and season-matched HSV negative patients (N=52).

Results: HSV-positive patients differed significantly from the HSV-negative ones only with regard to time of mechanical ventilation (13 days in the HSV-positive group versus 6 days in the HSV-negative group; p=0.002). Subgroup analysis in the patients aged >60 years and in those without bacterial detection revealed a similar trend (p=0.01; p=0.004). Mortality did not differ between both groups or between the HSV-positive patients treated with aciclovir and HSV-positive patients who were not. A high viral load (>10E+05 geq/ml) was associated with mechanical ventilation (20/21 vs. 17/29; p=0.004), ARDS (19/21 vs. 18/29; p=0.005), sepsis (18/21 vs. 14/29; p=0.008), detection of a bacterial pathogen in the same specimen (10/21 vs. 4/29; p=0.01), and longer ICU stay (25 vs. 30 days; p=0.04).

(Table 1 [Tab. 1])

Conclusions: Despite several associations with high viral load, the clinical outcome of HSV-positive patients did not differ significantly from the clinical outcome of HSV-negative patients. This finding may indicate that HSV viral loads in respiratory specimens are rather a symptom of clinically poor condition than a cause of it. Longitudinal and therapy studies are therefore needed to distinguish between HSV as a causative pathogen and HSV as a bystander of pneumonia / ARDS.