Abstract Rationale Cytomegalovirus (CMV) infection and reactivation exert a negative impact on critically ill patients with sepsis as the underlying condition. However, current research has not established a clear correlation between CMV detection in blood and lower respiratory tract (LRT) specimens. This study aimed to investigate the clinical characteristics and associations of CMV presence in blood and LRT specimens among severe pneumonia patients with sepsis. Methods A single-center, retrospective, observational cohort study was conducted from January 2021 to December 2023, enrolling 114 patients with pneumonic sepsis who were undergoing mechanical ventilation (MV) in the intensive care unit (ICU) of a national respiratory center hospital. Furthermore, we compared the presence of CMV in blood and LRT specimens among the subjects, clarifying differences in detection rates, clinical characteristics, and associations. Results Among the 114 study subjects, 18.4% of blood and 57.9% of LRT specimens tested positive for CMV. All of CMV-positive blood samples (100%) were also positive in LRT, and CMV load in LRT was 8.8 times higher than in blood samples. A strong correlation was observed between CMV load in LRT and in blood, with a predictive value for reactivation (P 0.05). The association between CMV positivity in the LRT and adverse clinical outcomes including duration of MV odds ratio (OR): 1.015 vs. 1.038; correlation coefficient (r): 0.301 vs. 0.185, Invasive MV (OR: 1.017 vs. 1.035; r: 0.283 vs. 0.190), and ICU stay (OR: 1.017 vs. 1.041; r: 0.348 vs. 0.236) was more pronounced than in blood. Conclusions The presence of CMV in LRT is higher and may predict reactivation in blood. Positive CMV detection in LRT correlates more strongly with poor prognosis than in blood. Detection of CMV in LRT outperforms blood specimens in severe pneumonia patients with sepsis, as it more effectively screens high-risk individuals. This abstract is funded by: None
Zhang et al. (Fri,) studied this question.