Bloodstream infections in patients undergoing extracorporeal membrane oxygenation

  • Jian-rong Wang The Affiliated Hangzhou Hospital of Nanjing Medical University
  • Jin-yu Huang The Affiliated Hangzhou Hospital of Nanjing Medical University
  • Wei Hu The Affiliated Hangzhou Hospital of Nanjing Medical University
  • Xue-ying Cai The Affiliated Hangzhou Hospital of Nanjing Medical University
  • Wei-hang Hu Zhejiang Hospital
  • Ying Zhu The Affiliated Hangzhou Hospital of Nanjing Medical University
Keywords: bloodstream infection, extracorporeal membrane oxygenation, pathogen, risk factors, prognosis

Abstract

Objective: We aimed to evaluate the incidence, risk factors, and prognosis of bloodstream infections (BSIs) during extracorporeal membrane oxygenation (ECMO) treatment in a Chinese population.

Methods: Patients receiving ECMO treatment from January 2013 to August 2019 were retrospectively studied. The incidence of BSIs was calculated. The clinical characteristics between patients with a BSI (BSI group) and without a BSI (non-BSI group).

Results: Among 69 included patients, 19 (27.5%) developed at least one BSI. Gram-negative bacteria (73.7%) were mainly responsible for the BSIs, with Klebsiella pneumoniae (6/19, 31.5%) ranking as the top related pathogen. The BSI group had a greater proportion of methicillin-resistant Staphylococcus aureus (MRSA) prophylactic regimens (52.6% vs. 26.0%, P = 0.036), a higher pre-ECMO Sequential Organ Failure Assessment (SOFA) score (11 vs. 8, P = 0.008), more applications of continuous renal replacement therapy (CRRT) during ECMO (63.1% vs. 36.1%, P = 0.042). Longer ECMO support duration, period of ventilator use before ECMO weaning and hospital stay were observed in the BSI group. The SOFA score (OR: 1.174; 95% CI: 1.039–1.326; P = 0.010) was an independent risk factor for BSIs.

Conclusion: BSIs during ECMO therapy frequently involve Gram-negative bacteria. Stringent care and monitoring should be provided for patients with high SOFA scores.

doi: https://doi.org/10.12669/pjms.36.6.2882

How to cite this:
Wang JR, Huang JY, Hu W, Cai XY, Hu WH, Zhu Y. Bloodstream infections in patients undergoing extracorporeal membrane oxygenation. Pak J Med Sci. 2020;36(6):1171-1176. doi: https://doi.org/10.12669/pjms.36.6.2882

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published
2020-08-19
How to Cite
Wang, J.- rong, Huang, J.- yu, Hu, W., Cai, X.- ying, Hu, W.- hang, & Zhu, Y. (2020). Bloodstream infections in patients undergoing extracorporeal membrane oxygenation. Pakistan Journal of Medical Sciences, 36(6). https://doi.org/10.12669/pjms.36.6.2882
Section
Original Articles