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Prevalence of Human Herpes Viruses in Bronchoalveolar Lavage of Critically Ill Children Undergoing Mechanical Ventilation at a Pediatric Intensive Care Unit Publisher



Amanati A1 ; Karimi A2 ; Fahimzad A2 ; Shamshiri AR3 ; Fallah F2 ; Mahdavi A4 ; Talebian M5
Authors
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Authors Affiliations
  1. 1. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  2. 2. Pediatric Infections Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Pediatric Anesthesiologists and Intensivist, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. BS of Nursery, Head Nurse of PICU, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Archives of Pediatric Infectious Diseases Published:2018


Abstract

Background: Critically ill children at the intensive care unit frequently develop hospital-acquired pneumonia (HAP). Human herpes viruses (HHVs), primarily or by reactivation may cause bronchopneumonitis in mechanically ventilated patients. The exact prevalence and role of HHVs in morbidity and mortality of pediatric patients undergoing mechanical ventilation is unclear. The current study was conducted to evaluate the prevalence of 5 Herpes viruses by polymerase chain reaction (PCR) method in bronchoalveolar lavage (BAL) samples in critically ill children at a pediatric intensive care unit (PICU). Methods: Overall, 140 bronchoalveolar lavage samples from 83 mechanically ventilated cases were studied. Samples were taken via the mini-BAL technique. Samples were analyzed by qualitative PCR for detection of herpes simplex virus type 1 and 2 (HSV1/HSV2), human herpes virus type 6 and 7 (HHV6/HHV7), Ebstein-Barr virus (EBV), and cytomegalovirus (CMV). Results: Out of 83 cases, 53% (44) were male and 47% (39) were female. The mean age was 29.12 ± 33.67 months (32.53 months in males and 25.29 months in females). The estimated prevalence of HSV1, HHV6, HHV7, EBV, and CMV were 2.4%, 13.2%, 2.4%, 7.2%, and 2.4%, respectively. Conclusions: Molecular study of BAL specimens and investigation of HHVsmaybe the first step in the evaluation of the possible role of these viruses in the development of viral pneumonia during VAP. The current results are useful for guiding other well-designed studies for correlation of viral load and clinical outcome in ill ventilated children. The Modified protected BAL may be of use as a safe modality in critically ill ventilated pediatric patients for investigation of possible viral (and also bacterial and fungal) infections. Local study of high-risk patients at the PICU and estimation of the true prevalence of HHVs infection may assist in finding the exact role of HHVs in mortality and morbidity of critically ill patients. © 2018, Archives of Pediatric Infectious Diseases.
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