Current practices in the diagnosis and management of HSV and CMV reactivation in German ICUs: an exploratory web-based survey

The study examined practices in the diagnosis and treatment of herpes simplex virus (HSV) and cytomegalovirus (CMV) reactivation in German intensive care units through an online survey. Between January and March 2025, 1,642 ICU directors were invited to participate, with 123 completed questionnaires returned (7.5% response rate). Standard procedures for HSV and CMV diagnostics were reported by only 33% of institutions for transplant recipients and 24% for immunocompromised patients. Virological testing was available several times per week with a median turnaround time of 2 days. The survey revealed substantial heterogeneity in diagnostic and therapeutic approaches among different units. Routine testing and pre-emptive or prophylactic antiviral strategies were more frequently used in transplant recipients, whereas in immunocompetent patients antiviral therapy was typically initiated only based on clinical suspicion.