OBJECTIVES: Demonstrate that DNA viremia is common in pediatric sepsis and quantitate its associations with host immune function and secondary infection risk. DESIGN: Retrospective analysis of a prospective cohort study. PATIENTS: Seventy-three children admitted with sepsis-induced organ failure. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: This study was performed as an ancillary investigation to a single-center prospective study of children with severe sepsis. Longitudinally collected, batched, frozen plasma was examined using real time-polymerase chain reaction for the presence of cytomegalovirus, Epstein-Barr virus, herpes simplex virus, human herpes virus-6, torque teno virus, and adenovirus DNA. Innate immune function was also measured longitudinally via quantification of ex vivo lipopolysaccharide -induced tumor necrosis factor-α production capacity. Viral DNAemia with a virus other than torque teno virus was detected in 28 of 73 subjects (38%) and included cytomegalovirus 5%, Epstein-Barr virus 11%, herpes simplex virus 4%, human herpes virus-6 8%, and adenovirus 26%. In addition, torque teno virus was detected in 89%. Epstein-Barr virus DNAemia was associated with preexisting immune suppression (p = 0.007) Viral DNAemia was associated with preexisting immune suppression and high risk for the subsequent development of secondary infection (p < 0.05 for both). Subjects with viral DNAemia had lower innate immune function over time compared with those who were virus negative (p < 0.05). CONCLUSIONS: DNAemia from multiple viruses can be detected in septic children and is strongly associated with preexisting immune suppression and secondary infection risk. The role of DNA viruses in the perpetuation of impaired host defense in this setting should be the subject of prospective study.
OBJECTIVES: Demonstrate that DNA viremia is common in pediatric sepsis and quantitate its associations with host immune function and secondary infection risk. DESIGN: Retrospective analysis of a prospective cohort study. PATIENTS: Seventy-three children admitted with sepsis-induced organ failure. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: This study was performed as an ancillary investigation to a single-center prospective study of children with severe sepsis. Longitudinally collected, batched, frozen plasma was examined using real time-polymerase chain reaction for the presence of cytomegalovirus, Epstein-Barr virus, herpes simplex virus, human herpes virus-6, torque teno virus, and adenovirus DNA. Innate immune function was also measured longitudinally via quantification of ex vivo lipopolysaccharide -induced tumor necrosis factor-α production capacity. Viral DNAemia with a virus other than torque teno virus was detected in 28 of 73 subjects (38%) and included cytomegalovirus 5%, Epstein-Barr virus 11%, herpes simplex virus 4%, human herpes virus-6 8%, and adenovirus 26%. In addition, torque teno virus was detected in 89%. Epstein-Barr virus DNAemia was associated with preexisting immune suppression (p = 0.007) Viral DNAemia was associated with preexisting immune suppression and high risk for the subsequent development of secondary infection (p < 0.05 for both). Subjects with viral DNAemia had lower innate immune function over time compared with those who were virus negative (p < 0.05). CONCLUSIONS: DNAemia from multiple viruses can be detected in septic children and is strongly associated with preexisting immune suppression and secondary infection risk. The role of DNA viruses in the perpetuation of impaired host defense in this setting should be the subject of prospective study.
Authors: R S Hotchkiss; K W Tinsley; P E Swanson; R E Schmieg; J J Hui; K C Chang; D F Osborne; B D Freeman; J P Cobb; T G Buchman; I E Karl Journal: J Immunol Date: 2001-06-01 Impact factor: 5.422
Authors: Jennifer A Muszynski; Ryan Nofziger; Kristin Greathouse; Jyotsna Nateri; Lisa Hanson-Huber; Lisa Steele; Kathleen Nicol; Jonathan I Groner; Gail E Besner; Corey Raffel; Susan Geyer; Osama El-Assal; Mark W Hall Journal: Shock Date: 2014-10 Impact factor: 3.454
Authors: Jared T Muenzer; Christopher G Davis; Kathy Chang; Robert E Schmidt; W Michael Dunne; Craig M Coopersmith; Richard S Hotchkiss Journal: Infect Immun Date: 2010-01-25 Impact factor: 3.441
Authors: Moonjoo Han; Anna L Roberts; Brooke A Migliore; Ana María Cárdenas; Scott L Weiss Journal: Pediatr Crit Care Med Date: 2020-04 Impact factor: 3.624
Authors: Derek Salud; Ron W Reeder; Russell K Banks; Kathleen L Meert; Robert A Berg; Athena Zuppa; Christopher J Newth; Mark W Hall; Michael Quasney; Anil Sapru; Joseph A Carcillo; Patrick S McQuillen; Peter M Mourani; James W Varni; Jerry J Zimmerman Journal: Pediatr Crit Care Med Date: 2022-08-01 Impact factor: 3.971
Authors: Matt S Zinter; Christopher C Dvorak; Madeline Y Mayday; Kensho Iwanaga; Ngoc P Ly; Meghan E McGarry; Gwynne D Church; Lauren E Faricy; Courtney M Rowan; Janet R Hume; Marie E Steiner; Emily D Crawford; Charles Langelier; Katrina Kalantar; Eric D Chow; Steve Miller; Kristen Shimano; Alexis Melton; Gregory A Yanik; Anil Sapru; Joseph L DeRisi Journal: Clin Infect Dis Date: 2019-05-17 Impact factor: 9.079