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Nosocomial Infections in Adult Patients Supported by Extracorporeal Membrane Oxygenation in a Cardiac Intensive Care Unit

Authors :
Simone Mornese Pinna
Iago Sousa Casasnovas
María Olmedo
Marina Machado
Miriam Juàrez Fernández
Carolina Devesa-Cordero
Alicia Galar
Ana Alvarez-Uria
Francisco Fernández-Avilés
Jorge García Carreño
Manuel Martínez-Sellés
Francesco Giuseppe De Rosa
Silvia Corcione
Emilio Bouza
Patricia Muñoz
Maricela Valerio
Source :
Microorganisms, Vol 11, Iss 4, p 1079 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

The use of venoarterial (VA) extracorporeal membrane oxygenation therapy (ECMO) in patients admitted to cardiac intensive care units (CICU) has increased. Data regarding infections in this population are scarce. In this retrospective study, we analyzed the risk factors, outcome, and predictors of in-hospital mortality due to nosocomial infections in patients with ECMO admitted to a single coronary intensive care unit between July 2013 and March 2019 treated with VA-ECMO for >48 h. From 69 patients treated with VA-ECMO >48 h, (median age 58 years), 29 (42.0%) patients developed 34 episodes of infections with an infection rate of 0.92/1000 ECMO days. The most frequent were ventilator-associated pneumonia (57.6%), tracheobronchitis (9.1%), bloodstream infections (9.1%), skin and soft tissue infections (9.1%), and cytomegalovirus reactivation (9.1%). In-hospital mortality was 47.8%, but no association with nosocomial infections was found (p = 0.75). The number of days on ECMO (OR 1.14, 95% CI 1.01–1.30, p = 0.029) and noninfectious complications were higher in the infected patients (OR: 3.8 95% CI = 1.05–14.1). A higher baseline creatinine value (OR: 8.2 95% CI = 1.12–60.2) and higher blood lactate level at 4 h after ECMO initiation (OR: 2.0 95% CI = 1.23–3.29) were significant and independent risk factors for mortality. Conclusions: Nosocomial infections in medical patients treated with VA-ECMO are very frequent, mostly Gram-negative respiratory infections. Preventive measures could play an important role for these patients.

Details

Language :
English
ISSN :
20762607
Volume :
11
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Microorganisms
Publication Type :
Academic Journal
Accession number :
edsdoj.f5bdbc4b4b3c98e2b8e2d11c92d0
Document Type :
article
Full Text :
https://doi.org/10.3390/microorganisms11041079