Analysis of risk factors and pathogen distribution of nosocomial infection during extracorporeal membrane oxygenation

Ren Yucheng; Wang Rui; Tong Yaowei; Zhou Wangtao; Li Ying; Song Yunlin

doi:10.13498/j.cnki.chin.j.ecc.2024.05.05

Abstract：Objective To analyze the risk factors and pathogen distribution of nosocomial infection (NIs) during extracorporeal membrane oxygenation (ECMO). Methods Patients who needed ECMO support in the intensive care center of the First Affiliated Hospital of Xinjiang Medical University from June 2018 to December 2023 were divided into infected group and non-infected group according to the etiological study. Univariate and multivariate Logistic regression analysis was used to analyze the risk factors of NIs during ECMO support,and the distribution of pathogens was analyzed. Results A total of 68 patients with ECMO support were enrolled in this study,with an average age of (55±13.21) years. There were 53 males (77.94％),40 cases in the infected group and 28 cases in the non-infected group,with 39 patients in V-V mode,19 patients in V-A mode and 10 patients in V-A-V mode. 40 patients (58.82％) had 51 times of NIs,the incidence rate was 75.00％,the disease density was 71.56 ‰ (/1000 ECMO d),and the lower respiratory tract infection was mainly found in 45 cases (88.24％). The main pathogens were gram-negative bacteria (38 strains,74.51％),and 17 strains of multidrug resistant strains accounted for 33.33％. Multivariate logistic regression analysis showed that blood lactate before ECMO support (OR=1.337,95％CI:1.023～1.748,P=0.033),creatinine value (OR=1.019,95％CI:1.001～1.038,P=0.043) and total ECMO duration (OR=1.524,95％CI:1.022～2.272,P=0.039) during ECMO support were independent risk factors for NIs. Conclusion The incidence of NIs was high during ECMO support,and the blood lactate level before ECMO support,creatinine value during ECMO support and ECMO duration were the independent risk factors. In view of the trend of high incidence of infection during ECMO support,active measures should be taken to prevent infection and strengthen theoretical training in health care to reduce infection and mortality.