Cytomegalovirus and burns : Current perceptions, awareness, diagnosis, and management strategies in the united states and germany

Trauma and immunosuppressed patients are at risk for cytomegalovirus (CMV) disease. Attributing pathogenicity in burn patients remains difficult and controversial because data are sparse. In this work, we surveyed U.S. and German burn centers and evaluated them for awareness, perceptions, diagnosis, and treatment of CMV in patients with burn injury. A total of 58% German (G) and 21% U.S. centers responded. CMV infection incidence was 1:280 G and 1:870 U.S. A total of 41% G and 78% U.S. burn centers considered CMV to be of minor importance and 41% G and 13% U.S. centers considered CMV to be of significant importance. A total of 70% G and 97% U.S. centers performed no admission screening. When testing, 70% G and 19% U.S. centers used serology; 52% G and 25% U.S. centers used body fluid viral isolation; and 43% G and 6% U.S. centers used leukocyte CMV-DNA analysis. A total of 72% G and 48% U.S. centers distinguished infection from disease. Human CMV disease was diagnosed by CMV-DNA (82% G, 19% U.S.), direct virus isolation (43% G, 13% U.S.), or RNA detection (26% G, 0% U.S.). A total of 43% G and 19% U.S. would treat the established disease. Establishing consistent guidelines for screening, diagnosis, and treatment seems prudent in caring for the immunocompromised burn patient.