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Nosocomial Infections in Neonates Receiving Extracorporeal Membrane Oxygenation

Published online by Cambridge University Press:  02 January 2015

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

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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