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Rates of nosocomial infection associated with interhospital transfer of patients receiving extracorporeal membrane oxygenation

Published online by Cambridge University Press:  25 June 2021

Joseph E. Marcus Open the ORCID record for Joseph E. Marcus [Opens in a new window] ,
Valerie G. Sams ,
James K. Aden ,
Andriy Batchinsky ,
Michal J. Sobieszczyk ,
Jason F. Okulicz  and
Alice E. Barsoumian
Joseph E. Marcus*
Affiliation:
Infectious Disease Service, Department of Internal Medicine, JBSA–Ft Sam Houston, San Antonio, Texas
Valerie G. Sams
Affiliation:
Department of Surgery, Brooke Army Medical Center, JBSA–Ft. Sam Houston, San Antonio, Texas
James K. Aden
Affiliation:
Biostatistics, Brooke Army Medical Center, JBSA–Ft Sam Houston, San Antonio, Texas
Andriy Batchinsky
Affiliation:
US Army Institute of Surgical Research, JBSA–Ft. Sam Houston, San Antonio, Texas
Michal J. Sobieszczyk
Affiliation:
Pulmonary Service, Department of Internal Medicine, JBSA–Ft Sam Houston, San Antonio, Texas
Jason F. Okulicz
Affiliation:
Infectious Disease Service, Department of Internal Medicine, JBSA–Ft Sam Houston, San Antonio, Texas
Alice E. Barsoumian
Affiliation:
Infectious Disease Service, Department of Internal Medicine, JBSA–Ft Sam Houston, San Antonio, Texas
*
Author for correspondence: Joseph E Marcus, Email: joseph.e.marcus3.mil@mail.mil
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Abstract

Objectives:

Critically ill patients requiring extracorporeal membrane oxygenation (ECMO) frequently require interhospital transfer to a center that has ECMO capabilities. Patients receiving ECMO were evaluated to determine whether interhospital transfer was a risk factor for subsequent development of a nosocomial infection.

Design:

Retrospective cohort study.

Setting:

A 425-bed academic tertiary-care hospital.

Patients:

All adult patients who received ECMO for >48 hours between May 2012 and May 2020.

Methods:

The rate of nosocomial infections for patients receiving ECMO was compared between patients who were cannulated at the ECMO center and patients who were cannulated at a hospital without ECMO capabilities and transported to the ECMO center for further care. Additionally, time to infection, organisms responsible for infection, and site of infection were compared.

Results:

In total, 123 patients were included in analysis. For the primary outcome of nosocomial infection, there was no difference in number of infections per 1,000 ECMO days (25.4 vs 29.4; P = .03) by univariate analysis. By Cox proportional hazard analysis, transport was not significantly associated with increased infections (hazard ratio, 1.7; 95% confidence interval, 0.8–4.2; P = .20).

Conclusion:

In this study, we did not identify an increased risk of nosocomial infection during subsequent hospitalization. Further studies are needed to identify sources of nosocomial infection in this high-risk population.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 7 , July 2022 , pp. 864 - 869
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. A portion of this work was presented at IDWeek 2020 on October 22, 2020, held virtually.

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