Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study
Authors' conclusion
In a nationwide cohort of COVID-19 patients receiving ECMO support, we observed a high incidence of ECMO-AI. ECMO-AI were not found associated with hospital death.
Study context
- Population
- COVID-19 patients supported by extracorporeal membrane oxygenation (ECMO) in France (ECMOSARS registry)602 analysed
- Participants
- 701 patients
- Exposure
- ECMO-associated infections (ECMO-AI) vs no ECMO-AI
- ECMO-AIn = 214
- Outcome
- Healthcare-associated infections (HAI) incidence and microbiology; impact of ECMO-AI on in-hospital mortality
Methodological detailsmulticentre registry, Cox multistate model
- Multicentre registry
- Cox multistate model
Main finding
As reported in the abstract
ECMO-AI incidence
| Group | Value | Incidence rate per 1000 ECMO days at risk |
|---|---|---|
| ECMO-AI | 36% | 27 |
ECMO-AI
Value36%
Incidence rate per 1000 ECMO days at risk27
- Bloodstream infection (BSI)
- 154
- Ventilator-associated pneumonia (VAP)
- 117
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Hospital deathCox multistate model | 1.00 (0.79–1.26) | P = 0.986 | |
| 0.512Hazard ratio (log scale) |
Microorganisms (BSI; VAP)
- Enterobacteriaceae
- 34% for BSI and 48% for VAP
- Enterococcus species
- 25% and 6%
- Non-fermenting Gram-negative bacilli
- 13% and 20%
- Fungal infections
- 10% for BSI and 3% for VAP
- Multidrug-resistant organisms
- 21% and 15%
Original publication
Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study. Crit Care. Published 20 February 2024. doi:10.
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