Viral DNAemia and Immune Suppression in Pediatric Sepsis

Sam Davila, E. Scott Halstead, Mark W. Hall, Allan Doctor, Russell Telford, Richard Holubkov, Joseph A. Carcillo, Gregory A. Storch

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)e14-e22
JournalPediatric Critical Care Medicine
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Torque teno virus
Sepsis
Pediatrics
Viruses
Human Herpesvirus 4
Coinfection
Prospective Studies
Simplexvirus
Cytomegalovirus
Adenoviridae
DNA Viruses
Viremia
DNA
Lipopolysaccharides
Real-Time Polymerase Chain Reaction
Cohort Studies
Tumor Necrosis Factor-alpha

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Davila, S., Halstead, E. S., Hall, M. W., Doctor, A., Telford, R., Holubkov, R., ... Storch, G. A. (2018). Viral DNAemia and Immune Suppression in Pediatric Sepsis. Pediatric Critical Care Medicine, 19(1), e14-e22. https://doi.org/10.1097/PCC.0000000000001376
Davila, Sam ; Halstead, E. Scott ; Hall, Mark W. ; Doctor, Allan ; Telford, Russell ; Holubkov, Richard ; Carcillo, Joseph A. ; Storch, Gregory A. / Viral DNAemia and Immune Suppression in Pediatric Sepsis. In: Pediatric Critical Care Medicine. 2018 ; Vol. 19, No. 1. pp. e14-e22.
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abstract = "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.",
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Davila, S, Halstead, ES, Hall, MW, Doctor, A, Telford, R, Holubkov, R, Carcillo, JA & Storch, GA 2018, 'Viral DNAemia and Immune Suppression in Pediatric Sepsis', Pediatric Critical Care Medicine, vol. 19, no. 1, pp. e14-e22. https://doi.org/10.1097/PCC.0000000000001376

Viral DNAemia and Immune Suppression in Pediatric Sepsis. / Davila, Sam; Halstead, E. Scott; Hall, Mark W.; Doctor, Allan; Telford, Russell; Holubkov, Richard; Carcillo, Joseph A.; Storch, Gregory A.

In: Pediatric Critical Care Medicine, Vol. 19, No. 1, 01.01.2018, p. e14-e22.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Viral DNAemia and Immune Suppression in Pediatric Sepsis

AU - Davila, Sam

AU - Halstead, E. Scott

AU - Hall, Mark W.

AU - Doctor, Allan

AU - Telford, Russell

AU - Holubkov, Richard

AU - Carcillo, Joseph A.

AU - Storch, Gregory A.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

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