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Detection of human cytomegalovirus in bronchoalveolar lavage of intensive care unit patients

Andrea Vergara, Catia Cilloniz, Nestor Luque, Carolina Garcia-Vidal, Javier Tejero, Rafael Perelló, Carmen María Lucena, Antoni Torres, María Angeles Marcos
European Respiratory Journal 2018 51: 1701332; DOI: 10.1183/13993003.01332-2017
Andrea Vergara
1Dept of Clinical Microbiology, Biomedical Diagnostic Center (CDB), Hospital Clínic of Barcelona, University of Barcelona, Institute for Global Health (ISGlobal), Barcelona, Spain
8These authors contributed equally to the study
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Catia Cilloniz
2Dept of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
3SGR 911, Centro de Investigatión Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
8These authors contributed equally to the study
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Nestor Luque
2Dept of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Carolina Garcia-Vidal
4Dept of Infectious Diseases, Hospital Clínic of Barcelona, Barcelona, Spain
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Javier Tejero
5University of Barcelona, Barcelona, Spain
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Rafael Perelló
6Emergency Dept, Hospital Clínic of Barcelona, Barcelona, Spain
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Carmen María Lucena
2Dept of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Antoni Torres
2Dept of Pneumology, Institut Clínic Respiratori (ICR), Hospital Clínic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
3SGR 911, Centro de Investigatión Biomédica en Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
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María Angeles Marcos
1Dept of Clinical Microbiology, Biomedical Diagnostic Center (CDB), Hospital Clínic of Barcelona, University of Barcelona, Institute for Global Health (ISGlobal), Barcelona, Spain
7Barcelona Centre for International Health Research (CRESIB), Institute for Global Health (ISGlobal), Barcelona, Spain
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  • For correspondence: mmarcos@clinic.cat
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Tables

  • TABLE 1

    Baseline characteristics, conditions and clinical outcomes, and their associated cytomegalovirus (CMV) PCR results in bronchoalveolar lavage

    VariableNegative CMV (n=98)Positive CMV (n=35)p-value
    Demographic
     Age years (median (IQR))62.0 (23.0)61.0 (24.0)0.37
     Men63 (64)23 (66)0.88
     Current smoker31 (36)7 (25)0.28
     Current alcohol consumer8 (10)2 (7)>0.99
    Immunocompromised#47 (48)25 (71)0.017
     HIV8 (8)3 (9)>0.99
     Transplant19 (19)9 (26)0.43
     Cancer16 (16)7 (20)0.62
     Systemic corticosteroids¶21 (21)17 (49)0.002
    Diagnosis at ICU admission0.73
     Respiratory failure59 (60)24 (69)
     Septic shock18 (18)5 (14)
     Cardiac failure9 (9)2 (6)
     Sepsis5 (5)1 (3)
     Other7 (7)3 (9)
    Previous antibiotic7 (7)3 (9)0.72
    Comorbidities+76 (78)26 (74)0.70
     Chronic respiratory disease27 (28)8 (23)0.55
     Chronic cardiovascular disease23 (24)6 (17)0.44
     Diabetes mellitus12 (12)6 (17)0.57
     Neurological disease11 (11)7 (20)0.25
     Chronic renal disease12 (12)7 (20)0.27
     Chronic liver disease4 (4)2 (6)0.65
     Arterial hypertension38 (39)18 (51)0.19
    Laboratory tests (median (IQR))
     Creatinine mg·mL−11.0 (1.0)1.2 (1.1)0.98
     C-reactive protein mg·dL−112.5 (15.9)11.9 (20.0)0.87
     White blood-cell count 109·L−110.0 (9.0)9.0 (12.0)0.41
    SOFA score at ICU admission (median (IQR))5 (6)5 (5)0.91
    Outcomes
     Pulmonary complications16 (39)5 (33)0.70
     NIMV59 (94)17 (94)>0.99
     IMV72 (92)26 (93)>0.99
     Hospital stay days (median (IQR))35.0 (33.0)46.0 (62.0)0.017
     ICU stay days (median (IQR))19.5 (21.5)31.5 (69.0)0.070
     30-day mortality38 (41)21 (64)0.024

    Data are presented as n (%) unless otherwise stated. Values in bold are for when p<0.05. IQR: interquartile range; ICU: intensive care unit; SOFA: sepsis-related organ failure assessment; NIMV: noninvasive mechanical ventilation; IMV: invasive mechanical ventilation. #: subjects may have more than one immunocompromising condition; ¶: daily doses >20 mg prednisolone-equivalent for more than 2 weeks in the month previous to admission; +: subjects may have more than one comorbid condition.

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    Detection of human cytomegalovirus in bronchoalveolar lavage of intensive care unit patients
    Andrea Vergara, Catia Cilloniz, Nestor Luque, Carolina Garcia-Vidal, Javier Tejero, Rafael Perelló, Carmen María Lucena, Antoni Torres, María Angeles Marcos
    European Respiratory Journal Feb 2018, 51 (2) 1701332; DOI: 10.1183/13993003.01332-2017

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    Detection of human cytomegalovirus in bronchoalveolar lavage of intensive care unit patients
    Andrea Vergara, Catia Cilloniz, Nestor Luque, Carolina Garcia-Vidal, Javier Tejero, Rafael Perelló, Carmen María Lucena, Antoni Torres, María Angeles Marcos
    European Respiratory Journal Feb 2018, 51 (2) 1701332; DOI: 10.1183/13993003.01332-2017
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