학술논문
Healthcare-associated infections in patients with severe COVID-19 supported with extracorporeal membrane oxygenation: a nationwide cohort study
Document Type
Report
Author
Nesseler, Nicolas; Mansour, Alexandre; Schmidt, Matthieu; Para, Marylou; Porto, Alizée; Falcoz, Pierre-Emmanuel; Mongardon, Nicolas; Fougerou, Claire; Ross, James T.; Beurton, Antoine; Gaide-Chevronnay, Lucie; Guinot, Pierre-Grégoire; Lebreton, Guillaume; Flecher, Erwan; Vincentelli, André; Massart, Nicolas; Fouquet, Olivier; Pierrot, Marc; Chocron, Sidney; Flicoteaux, Guillaume; Mauriat, Philippe; Ouattara, Alexandre; Roze, Hadrien; Huet, Olivier; Fischer, Marc-Olivier; Bellaïche, Raphel; Constant, Ophélie; De Roux, Quentin; André, L. Y.; Meffert, Arnaud; Merle, Jean-Claude; Picard, Lucile; Skripkina, Elena; Folliguet, Thierry; Fiore, Antonio; D'ostrevy, Nicolas; Morgan, Marie-Catherine; Nguyen, Maxime; Terzi, Nicolas; Colin, Gwenhaël; Fabre, Olivier; Astaneh, Arash; Issard, Justin; Fadel, Elie; Fabre, Dominique; Guihaire, Julien; Ion, Iolande; Menager, Jean Baptiste; Mitilian, Delphine; Mercier, Olaf; Stephan, François; Thes, Jacques; Jouan, Jerôme; Duburcq, Thibault; Loobuyck, Valentin; Moussa, Mouhammed; Manganiello, Sabrina; Mugnier, Agnes; Rousse, Natacha; Desebbe, Olivier; Fellahi, Jean-Luc; Henaine, Roland; Pozzi, Matteo; Riad, Zakaria; Guervilly, Christophe; Hraiech, Sami; Papazian, Laurent; Castanier, Matthias; Chanavaz, Charles; Cadoz, Cyril; Gette, Sebastien; Louis, Guillaume; Portocarrero, Erick; Gaudard, Philippe; Brini, Kais; Bischoff, Nicolas; Kimmoun, Antoine; Levy, Bruno; Perez, Pierre; Bourdiol, Alexandre; Hourmant, Yannick; Mahé, Pierre-Joachim; Rozec, Bertrand; Vourc'h, Mickaël; Aubert, Stéphane; Bazalgette, Florian; Roger, Claire; Jaquet, Pierre; Lortat-Jacob, Brice; Mordant, Pierre; Nataf, Patrick; Patrier, Juliette; Provenchere, Sophie; Roué, Morgan; Sonneville, Romain; Tran-Dinh, Alexy; Wicky, Paul-Henri; Al Zreibi, Charles; Cholley, Bernard; Guyonvarch, Yannis; Hamada, Sophie; Barbanti, Claudio; Bertier, Astrid; Harrois, Anatole; Matiello, Jordi; Kerforne, Thomas; Lacroix, Corentin; Brechot, Nicolas; Combes, Alain; Chommeloux, Juliette; D'alessandro, Cosimo; Demondion, Pierre; Demoule, Alexandre; Dres, Martin; Fadel, Guillaume; Fartoukh, Muriel; Hekimian, Guillaume; Juvin, Charles; Leprince, Pascal; Levy, David; Luyt, Charles Edouard; Schoell, Thibaut; Fillâtre, Pierre; Jonas, Maud; Allou, Nicolas; Muccio, Salvatore; Di Perna, Dario; Ruggieri, Vito-Giovanni; Mourvillier, Bruno; Anselmi, Amedeo; Bounader, Karl; Launey, Yoann; Lebouvier, Thomas; Parasido, Alessandro; Reizine, Florian; Esvan, Maxime; Seguin, Philippe; Besnier, Emmanuel; Carpentier, Dorothée; Clavier, Thomas; Olland, Anne; Villard, Marion; Bounes, Fanny; Labaste, François; Minville, Vincent; Guillon, Antoine; Fedun, Yannick
Source
Critical Care. February 20, 2024, Vol. 28 Issue 1
Subject
Language
English
ISSN
1364-8535
Abstract
Background Both critically ill patients with coronavirus disease 2019 (COVID-19) and patients receiving extracorporeal membrane oxygenation (ECMO) support exhibit a high incidence of healthcare-associated infections (HAI). However, data on incidence, microbiology, resistance patterns, and the impact of HAI on outcomes in patients receiving ECMO for severe COVID-19 remain limited. We aimed to report HAI incidence and microbiology in patients receiving ECMO for severe COVID-19 and to evaluate the impact of ECMO-associated infections (ECMO-AI) on in-hospital mortality. Methods For this study, we analyzed data from 701 patients included in the ECMOSARS registry which included COVID-19 patients supported by ECMO in France. Results Among 602 analyzed patients for whom HAI and hospital mortality data were available, 214 (36%) had ECMO-AI, resulting in an incidence rate of 27 ECMO-AI per 1000 ECMO days at risk. Of these, 154 patients had bloodstream infection (BSI) and 117 patients had ventilator-associated pneumonia (VAP). The responsible microorganisms were 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 were also observed (10% for BSI and 3% for VAP), as were multidrug-resistant organisms (21% and 15%, respectively). Using a Cox multistate model, ECMO-AI were not found associated with hospital death (HR = 1.00 95% CI [0.79-1.26], p = 0.986). Conclusions 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. Trial registration number NCT04397588 (May 21, 2020). Keywords: ECLS, SARS-CoV 2, Nosocomial infections, Ventilator-associated pneumonia, Bloodstream infections
Author(s): Nicolas Nesseler[sup.1,2,3,29] , Alexandre Mansour[sup.1,4] , Matthieu Schmidt[sup.5,6] , Marylou Para[sup.7,8] , Alizée Porto[sup.9] , Pierre-Emmanuel Falcoz[sup.10,11,12] , Nicolas Mongardon[sup.13,14,15] , Claire Fougerou[sup.16,17] , James T. Ross[sup.18] , Antoine [...]
Author(s): Nicolas Nesseler[sup.1,2,3,29] , Alexandre Mansour[sup.1,4] , Matthieu Schmidt[sup.5,6] , Marylou Para[sup.7,8] , Alizée Porto[sup.9] , Pierre-Emmanuel Falcoz[sup.10,11,12] , Nicolas Mongardon[sup.13,14,15] , Claire Fougerou[sup.16,17] , James T. Ross[sup.18] , Antoine [...]