title: Impact of bloodstream infections on catheter colonization during extracorporeal membrane oxygenation.
abstract: There are concerns about secondary extracorporeal membrane oxygenation (ECMO) catheter infections in bacteremic patients. We investigated the association between blood stream infection (BSI) and ECMO catheter colonization. From January 2012 to August 2014, 47 adults who received ECMO support were enrolled. The ECMO catheter tip was cultured at the end of the ECMO procedure. The enrolled patients were classified into two groups according to the presence of BSI during ECMO support and analyzed with respect to ECMO catheter colonization. Of 47 cases, BSI during ECMO was identified in 13 patients (27.7 %). ECMO catheter colonization was identified in 6 (46.2 %) patients in the BSI group and 3 (8.8 %) in the non-BSI group. BSI during ECMO support was independently associated with ECMO catheter colonization [odds ratio (OR) 5.55; 95 % confidence interval (CI) 1.00-30.73; p = 0.049]. The organisms colonizing ECMO catheters in the setting of primary BSI were predominantly Gram-positive cocci and Candida species. Acinetobacter baumannii was the most common colonizing pathogen in the setting of secondary BSI. All the organisms colonizing ECMO catheters were multi-drug resistant organisms, including methicillin-resistant S. aureus, Candida glabrata, and carbapenem-resistant A. baumannii. ECMO catheters may become contaminated with multi-drug resistant pathogens in the presence of BSI. Therefore, ECMO should be applied cautiously in septic patients with bacteremia caused by multi-drug resistant pathogens.
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Dong Wan
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Hye Ju
authors.initials: HJ
authors.lastname: Yeo
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea. popeyes0212@hanmail.net.
authors.forename: Woo Hyun
authors.initials: WH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Doo Soo
authors.initials: DS
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan-si, 626-770, Korea.
authors.forename: Yun Seong
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsa, Korea.
authors.forename: Bong Soo
authors.initials: BS
authors.lastname: Son
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsa, Korea.
authors.forename: Do Hyung
authors.initials: do H
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D016470:Bacteremia / Q000150:complications* / Q000382:microbiology; D055499:Catheter-Related Infections / Q000382:microbiology*; D057785:Catheters / Q000009:adverse effects; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Blood stream infection; Catheter-related infection; Extracorporeal membrane oxygenation