title: Nosocomial infections in neonates receiving extracorporeal membrane oxygenation.
abstract: OBJECTIVE
  To determine the incidence of, and risk factors for, nosocomial infections in neonates during and after treatment with extracorporeal membrane oxygenation (ECMO).
  
  
  METHODS
  A retrospective cohort study of all infants treated with ECMO during a 4-year period.
  
  
  METHODS
  26 neonates experiencing 32 nosocomial infections, and 54 neonates with no nosocomial infections.
  
  
  METHODS
  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.
authors.affiliation: Division of Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, PA 19104, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Coffin
authors.forename: L M
authors.initials: LM
authors.lastname: Bell
authors.forename: M
authors.initials: M
authors.lastname: Manning
authors.forename: R
authors.initials: R
authors.lastname: Polin
mesh_terms: D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007234:Infant, Premature; D007235:Infant, Premature, Diseases; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D009017:Morbidity; D015143:Philadelphia; D012189:Retrospective Studies; D012307:Risk Factors