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Microbiological Spectrum of Nosocomial ECMO Infections in a Tertiary Care Center.

Authors
  • Selçuk, Ümmühan Nehir1
  • Sargın, Murat1
  • Baştopçu, Murat1
  • Mete, Evren Müge Taşdemir1
  • Erdoğan, Sevinç Bayer1
  • Öcalmaz, Şeyda2
  • Orhan, Gökçen1
  • Aka, Serap Aykut1
  • 1 Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. , (Turkey)
  • 2 Department of Infectious Diseases and Clinical Microbiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey. , (Turkey)
Type
Published Article
Journal
Brazilian journal of cardiovascular surgery
Publication Date
Jun 01, 2021
Volume
36
Issue
3
Pages
338–345
Identifiers
DOI: 10.21470/1678-9741-2020-0077
PMID: 33355788
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment in cardiogenic and respiratory shock. It is prone to various complications, infection being among the most frequent. This study aims to define the prevalence and characteristics of infections in ECMO patients in a tertiary care center for cardiac diseases. All ECMO patients between 2012 and 2016 in a single cardiac center were retrospectively included. Demographic data, ECMO indications, type, site, duration, and infection-related data were recorded. Data were analyzed among all patients and separately between pediatric and adult patient groups. One hundred and twenty-six patients, 66 (53.4%) pediatric and 60 (47.6%) adult, received ECMO within the study period. Mean age was 3.54±4.27 years in the pediatric group and 54.92±15.57 years in the adult group. The main indication for ECMO was postcardiotomy shock (77.8%). Forty-six (36.5%) of all cases developed a culture-proven nosocomial infection with a rate of 49/1000 ECMO days. Infection was associated with > 5 days of ECMO duration and hemodialysis requirement in all patients and lower age in the pediatric group. The most frequent infection site was the lower respiratory tract (14.3%), while the most common isolated organisms were Klebsiella (8.7%) and Streptococcus (4.8%) species. The respiratory tract is the most common site of infection, however, all sites impose a threat to recovery, with longer treatment durations required for patients with culture-proven infections. A better understanding of the infectious spectrum and its effect on the mortality and morbidity is required for more successful treatment of ECMO patients.

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