Almudena Martínez, María Marín-Cerezuela, Carmen Carrasco, Juan Frasquet, Ricardo Gimeno, Francisca Perez-Esteban, Faustino Álvarez, Javier Pemán, Álvaro Castellanos, Paula Ramirez
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引用次数: 0
Abstract
Background: Nosocomial bloodstream infections (BSIs) in critically ill patients can cause clinical deterioration, extend intensive care unit (ICU) stays, and increase mortality risk. Extracorporeal membrane oxygenation support (ECMO) is a known risk factor for BSI, and infections in these patients are assumed to have a worse prognosis. However, no comparative studies exist between ECMO and non-ECMO patients.
Methods: A three-year prospective observational study was conducted in a 24-bed medical ICU. Consecutive nosocomial BSIs episodes were recorded, and BSIs in mechanically ventilated patients were analyzed based on ECMO treatment status.
Findings: A total of 98 BSI episodes were included: 30 (30.6%) in ECMO and 68 (69.3%) in non-ECMO patients. The total number of ECMO patients during the study period was 110, with a bacteraemia rate of 27.7% (20.26 episodes per 1000 treatment-days). In non-ECMO patients, the BSI rate was 7.9% (p<0.001). ECMO patients were younger and had fewer co-morbidities. BSI type and aetiology were similar between groups, but severity was higher in ECMO patients. Although multidrug-resistant microorganisms were more frequent in ECMO patients, the appropriate treatment rate was similar. ICU-mortality was 66.6% in ECMO patients and 30.8% in non-ECMO patients (p <0.001). However, CRRT (OR 3.67), SOFA score (OR 1.54) and COVID-19 diagnosis (OR 1.54) were the only independent risk factors associated with mortality in BSI patients.
Conclusion: Although BSI was more frequent and severe in ECMO patients, ECMO support was not independently related to mortality in patients with healthcare-associated BSI.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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