Photo Credit: Pijitra Phomkham

The following is a summary of “Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study,” published in the February 2024 issue of Critical Care by Nesseler al.

Despite high healthcare-associated infection (HAI) rates in COVID-19 and extracorporeal membrane oxygenation (ECMO) patients, data on their combined impact and specific risk factors in severe COVID-19 ECMO cases remains scarce.

Researchers conducted a retrospective study to investigate the rate and types of HAI in critically ill COVID-19 patients receiving ECMO, further analyzing the impact of these ECMO-associated infections (ECMO-AI) on their in-hospital mortality.

They examined information from 701 individuals documented in the ECMOSARS database, encompassing COVID-19 cases receiving ECMO assistance in France.

The results showed 602 patients analyzed for HAI and hospital mortality data, 214 (36%) experienced ECMO-associated infections (ECMO-AI), equating to an incidence rate of 27 ECMO-AI per 1000 ECMO days. Among these cases, 154 had bloodstream infections (BSI) and 117 had ventilator-associated pneumonia (VAP). The causative microorganisms included Enterobacteriaceae (34% for BSI and 48% for VAP), Enterococcus species (25% and 6%, respectively), and non-fermenting Gram-negative bacilli (13% and 20%, respectively). Fungal infections occurred in 10% of BSI cases and 3% of VAP cases, while multidrug-resistant organisms were present in 21% and 15%, respectively. Utilizing a Cox multistate model, ECMO-AI did not show an association with hospital mortality (HR = 1.00, 95% CI [0.79–1.26], P=0.986).

They concluded that despite a high prevalence of ECMO-associated infections in a national cohort of COVID-19 patients receiving ECMO, these infections did not significantly impact in-hospital mortality.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04832-3