Analysis of Pathogenic Bacteria and Associated Risk Factors of Bloodstream Infections in ICU Patients Undergoing ECMO Support Using mNGS Technology

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2025-04-24 DOI:10.1155/ijcp/4985868

Jie Kang, Yi Hang, Zheng Liu, Man Yuan, Xiaosong Qiu, Ying Ye, Yuzhu Zang, Xiaobo Huang, Siyuan Song, Yi Wang

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引用次数: 0

Abstract

Objective: To analyze the characteristics of pathogens and related risk factors of bloodstream infections (BSI) in patients undergoing ECMO support using mNGS technology.

Methods: A retrospective analysis was conducted on 59 patients who received ECMO support in the Emergency Intensive Care Unit (EICU) of the Affiliated Hospital of Xuzhou Medical University from January 2021 to March 2024. The patients were divided into two groups based on the presence of BSI: the infection group (BSI group) and the noninfection group (N-BSI group). The clinical data of the two groups were compared, and the characteristics of pathogens were analyzed using mNGS technology. Logistic regression was used to analyze the related risk factors for BSI associated with ECMO.

Results: (1) The incidence of BSI in patients undergoing ECMO support was 20.34%. Compared to the N-BSI group, the BSI group had significantly higher levels of procalcitonin (14.9 ± 7.2 vs. 9.4 ± 4.7), C-reactive protein (140.58 ± 24.64 vs. 87.26 ± 11.06), blood lactate (8.55 ± 1.40 vs. 5.07 ± 0.55), and ECMO catheter indwelling time (12.00 ± 1.71 vs. 7.96 ± 0.76) (p < 0.05). (2) mNGS detection indicated that the BSI group mainly identified viruses and Gram-negative bacilli (G-), with Acinetobacter baumannii being the most prevalent pathogen. The resistance genes were predominantly blaTEM, which confers resistance to penicillins and cephalosporins. (3) Logistic regression analysis revealed that diabetes, ECMO indwelling time, blood lactate levels, and G-bacilli infection were risk factors for BSI during ECMO.

Conclusion: Gram-negative bacteria are the primary pathogens in BSI among patients undergoing ECMO support. Diabetes, ECMO catheter indwelling time, and elevated blood lactate are independent risk factors for these infections. Rational selection of antibiotics and strengthened management of related factors can effectively control the occurrence of BSI during ECMO support.

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应用mNGS技术进行ECMO支持的ICU患者血流感染病原菌及相关危险因素分析

目的分析使用 mNGS 技术接受 ECMO 支持的患者血流感染 (BSI) 的病原体特征和相关风险因素。方法：对 59 名使用 mNGS 技术进行 ECMO 支持的患者进行回顾性分析：对 2021 年 1 月至 2024 年 3 月期间在徐州医科大学附属医院急诊重症监护室（EICU）接受 ECMO 支持的 59 例患者进行回顾性分析。根据是否出现 BSI 将患者分为两组：感染组（BSI 组）和非感染组（N-BSI 组）。比较两组的临床数据，并使用 mNGS 技术分析病原体的特征。采用逻辑回归分析与 ECMO 相关的 BSI 风险因素。结果：（1）接受 ECMO 支持的患者 BSI 发生率为 20.34%。与 N-BSI 组相比，BSI 组的降钙素原（14.9±7.2 vs. 9.4±4.7）、C 反应蛋白（140.58±24.64 vs. 87.26±11.06）、血乳酸（8.55±1.40 vs. 5.07±0.55）和 ECMO 导管留置时间（12.00±1.71 vs. 7.96±0.76）水平明显更高（P <0.05）。(2）mNGS 检测表明，BSI 组主要发现病毒和革兰氏阴性杆菌（G-），其中鲍曼不动杆菌是最常见的病原体。耐药基因主要是 blaTEM，可产生对青霉素类和头孢菌素的耐药性。(3) 逻辑回归分析显示，糖尿病、ECMO 留置时间、血乳酸水平和 G 型杆菌感染是 ECMO 期间发生 BSI 的风险因素。结论在接受 ECMO 支持的患者中，革兰氏阴性菌是 BSI 的主要病原体。糖尿病、ECMO 导管留置时间和血乳酸升高是这些感染的独立风险因素。合理选择抗生素并加强对相关因素的管理，可有效控制 ECMO 支持期间 BSI 的发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.