Hostname: page-component-cb9f654ff-hqlzj Total loading time: 0 Render date: 2025-08-29T19:46:06.405Z Has data issue: false hasContentIssue false
  • English
  • Français

Nosocomial Infections in Neonates Receiving Extracorporeal Membrane Oxygenation

Published online by Cambridge University Press:  02 January 2015

Susan E. Coffin ,
Louis M. Bell ,
MaryLou Manning  and
Richard Polin
Susan E. Coffin*
Affiliation:
Divisions of Immunologic and Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Louis M. Bell
Affiliation:
Divisions of Immunologic and Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania Department of Infection Control, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
MaryLou Manning
Affiliation:
Department of Infection Control, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Richard Polin
Affiliation:
Neonatology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
*
Division of Immunologic and Infectious Diseases, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the incidence of, and risk factors for, nosocomial infections in neonates during and after treatment with extracorporeal membrane oxygenation (ECMO).

Design:

A retrospective cohort study of all infants treated with ECMO during a 4-year period.

Patients:

26 neonates experiencing 32 nosocomial infections, and 54 neonates with no nosocomial infections.

Setting:

A large, urban children's hospital.

Results:

30% of neonates treated with ECMO experienced at least one nosocomial infection. The rate of nosocomial infections was 10.3 per 1,000 patient-days. Risk factors significantly associated with nosocomial infection included duration of ECMO >7 days (mean, 12 vs 7 days; odds ratio [OR], 2.84; 95% confidence interval [CI95], 0.96-8.56); neonatal intensive care-unit stay >21 days (mean, 44 vs 19 days; OR, 8.73; CI95, 2.49-31.94); hospitalization >50 days (mean, 63 vs 29 days; OR, 5.44; CI95, 1.47-20.87); and surgical procedure before or during ECMO (46% vs 22%; OR, 4.58; CI95, 1.25 to 17.38).

Conclusions:

Nosocomial infections occurred in 30% of patients undergoing ECMO. Although nosocomial infections were not associated with an increase in mortality, hospitalization was prolonged.

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 2 , February 1997 , pp. 93 - 96
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1. Kanto, WP. A decade of experience with neonatal extracorporeal membrane oxygenation. J Pediatr 1994;124:335–347.Google Scholar
2. Stolar, CJH, Snedecor, SM, Bartlett, RH. Extracorporeal membrane oxygenation and neonatal respiratory failure: experience from the extracorporeal life support organization. J Pediatr Surg 1991;26:563–571.Google Scholar
3. Fagon, J-Y, Novara, A, Stephan, F, Girou, E, Safar, M. Mortality attributable to nosocomial infections in the ICU. Infect Control Hosp Epidemiol 1994;15:428–434.CrossRefGoogle ScholarPubMed
4. Maki, DG. Infections associated with intravascular lines. In: Remington, JS, Swartz, MN, eds. Current Clinical Topics in Infectious Diseases-3. New York, NY: McGraw-Hill Book Co; 1982.Google Scholar
5. Watson, JW, Brown, DM, Lally, KP, Null, D, Clark, R. Complications of extracorporeal membrane oxygenation in neonates. South Med J 1990;83:1262–1265.CrossRefGoogle ScholarPubMed
6. Cornish, JD, Wight, NE. Complications of neonatal extracorporeal membrane oxygenation. J Pediatr 1990;116:1005–1006.Google Scholar
7. Toomasian, JM, Snedecor, SM, Cornell, RG, Cilley, RE, Bartlett, RH. National experience with extracorporeal membrane oxygenation for newborn respiratory failure. Trans Am Soc Artif Intern Organs 1988;34:140–147.Google Scholar
8. Reuben, AG, Musher, DM, Hamill, RJ, Broucke, I. Polymicrobial bacteremia: clinical and microbiologic patterns. Rev Infect Dis 1989;11:161–183.CrossRefGoogle ScholarPubMed
9. Atkinson, JB, Kitagawa, H, Humpheries, B. Major surgical intervention during extracorporeal membrane oxygenation in newborn infants. J Pediatr 1990;116:1197–1198.Google Scholar
10. Zach, TL, Steinhorn, RB, Georgieff, MK, Mills, MM, Green, TP. Leukopenia associated with extracorporeal membrane oxy-genation in newborn infants. J Pediatr 1990;116:440–443.CrossRefGoogle Scholar
11. Bell, LM, Baker, MD, Beatty, D, Taylor, L. Infections in severely traumatized children. J Pediatr Surg 1992;27:1394–1398.Google Scholar