Nosocomial infections in neonates receiving extracorporeal membrane oxygenation.
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.
Coffin
S E
SE
Division of Immunologic and Infectious Diseases, Children's Hospital of Philadelphia, PA 19104, USA.
Bell
L M
LM
Manning
M
M
Polin
R
R
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